title: Evidence-based approach to revising the SCAT2: introducing the SCAT3.
abstract: The Sport Concussion Assessment Tool 2 (SCAT2), which evolved from the 2008 Concussion in Sport Group (CISG) Consensus meeting, has been widely used internationally for the past 4 years. Although the instrument is considered very practical and moderately effective for use by clinicians who manage concussion, the utility and sensitivity of a 100-point scoring system for the SCAT2 has been questioned. The 2012 CISG Consensus Meeting provided an opportunity for several of the world's leading concussion researchers and clinicians to present data and to share experiences using the SCAT2. The purpose of this report is to consider recommendations by the CISG, and to review the current literature to identify the most sensitive and reliable concussion assessment components for inclusion in a revised version-the SCAT3. Through this process, it was determined that important clinical information can be ascertained in a streamlined manner through the use of a multimodal instrument such as the SCAT3. This test battery should include an initial assessment of injury severity using the Glasgow Coma Scale, immediately followed by observing and documenting concussion signs. Once this is complete, symptom endorsement and symptom severity, neurocognitive function and balance function should be assessed in any athlete suspected of sustaining a concussion. There is no evidence to support the use of a composite/total score; however, there is good evidence to support the use of each component (scored independently) in a revised assessment tool.
authors.affiliation: Department of Exercise and Sport Science, Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, University of North Carolina at Chapel Hill, NC 27599, USA. gus@email.unc.edu
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Guskiewicz
authors.forename: Johna
authors.initials: J
authors.lastname: Register-Mihalik
authors.forename: Paul
authors.initials: P
authors.lastname: McCrory
authors.forename: Michael
authors.initials: M
authors.lastname: McCrea
authors.forename: Karen
authors.initials: K
authors.lastname: Johnston
authors.forename: Michael
authors.initials: M
authors.lastname: Makdissi
authors.forename: Jirí
authors.initials: J
authors.lastname: Dvorák
authors.forename: Gavin
authors.initials: G
authors.lastname: Davis
authors.forename: Willem
authors.initials: W
authors.lastname: Meeuwisse
mesh_terms: D001259:Ataxia / Q000175:diagnosis; D001265:Athletic Injuries / Q000175:diagnosis*; D001924:Brain Concussion / Q000175:diagnosis*; D019317:Evidence-Based Medicine; D006801:Humans; D010808:Physical Examination / Q000379:methods; D038223:Post-Concussion Syndrome / Q000175:diagnosis; D004856:Postural Balance; D011795:Surveys and Questionnaires / Q000592:standards; D015599:Trauma Severity Indices