title: Do family physicians, emergency department physicians, and pediatricians give consistent sport-related concussion management advice?
abstract: OBJECTIVE
  To identify differences and gaps in recommendations to patients for the management of sport-related concussion among FPs, emergency department physicians (EDPs), and pediatricians.
  
  
  METHODS
  A self-administered, multiple-choice survey was e-mailed to FPs, EDPs, and pediatricians. The survey had been assessed for content validity.
  
  
  METHODS
  Two community teaching hospitals in the greater Toronto area in Ontario.
  
  
  METHODS
  Two hundred seventy physicians, including FPs, EDPs, and pediatricians, were invited to participate.
  
  
  METHODS
  Identification of sources of concussion management information, usefulness of concussion diagnosis strategies, and whether physicians use common terminology when explaining cognitive rest strategies to patients after sport-related concussions.
  
  
  RESULTS
  The response rate was 43.7%. Surveys were completed by 70 FPs, 23 EDPs, and 11 pediatricians. In total, 49% of FP, 52% of EDP, and 27% of pediatrician respondents reported no knowledge of any consensus statements on concussion in sport, and 54% of FPs, 86% of EDPs, and 78% of pediatricians never used the Sport Concussion Assessment Tool, version 2. Only 49% of FPs, 57% of EDPs, and 36% of pediatricians always advised cognitive rest.
  
  
  CONCLUSIONS
  This study identified large gaps in the knowledge of concussion guidelines and implementation of recommendations for treating patients with sport-related concussions. Although some physicians recommended physical and cognitive rest, a large proportion failed to consistently advise this strategy. Better knowledge transfer efforts should target all 3 groups of physicians.
authors.affiliation: Family physician with a special interest in sport and exercise medicine practising in Toronto, Ont.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Stoller
authors.affiliation: Assistant Professor in the Department of Family and Community Medicine at the University of Toronto. james.carson@utoronto.ca.
authors.forename: James D
authors.initials: JD
authors.lastname: Carson
authors.affiliation: Medical student at the Medical University of the Americas in Nevis.
authors.forename: Alisha
authors.initials: A
authors.lastname: Garel
authors.affiliation: Graduate of the University of King's College in Halifax, NS.
authors.forename: Paula
authors.initials: P
authors.lastname: Libfeld
authors.affiliation: Student at York University in North York, Ont.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Snow
authors.affiliation: Assistant Professor in the Department of Family and Community Medicine at the University of Toronto.
authors.forename: Marcus
authors.initials: M
authors.lastname: Law
authors.affiliation: Associate Professor in the Department of Rehabilitation and Affiliated Professor in the Department of Family Medicine at Laval University in Quebec.
authors.forename: Pierre
authors.initials: P
authors.lastname: Frémont
mesh_terms: D001265:Athletic Injuries / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D001924:Brain Concussion / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D002648:Child; D019468:Disease Management; D004636:Emergency Service, Hospital / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D009864:Ontario; D010372:Pediatrics / Q000592:standards*; D010820:Physicians / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011364:Professional Practice / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care