title: Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine.
abstract: It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.].
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Lombardi
authors.forename: Bradford
authors.initials: B
authors.lastname: Tucker
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Freedman
authors.forename: Luke S
authors.initials: LS
authors.lastname: Austin
authors.forename: Brandon
authors.initials: B
authors.lastname: Eck
authors.forename: Matthew
authors.initials: M
authors.lastname: Pepe
authors.forename: Fotios P
authors.initials: FP
authors.lastname: Tjoumakaris
mesh_terms: D000293:Adolescent; D056352:Athletes; D001265:Athletic Injuries / Q000175:diagnosis* / Q000453:epidemiology; D001924:Brain Concussion / Q000175:diagnosis / Q000453:epidemiology; D032921:Consensus; D003288:Contusions / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D015588:Observer Variation; D009985:Orthopedics / Q000592:standards* / Q000706:statistics & numerical data; D026761:Physical Therapy Specialty / Q000592:standards* / Q000706:statistics & numerical data; D012017:Referral and Consultation; D012574:Schools; D013177:Sports; D013178:Sports Medicine; D013180:Sprains and Strains / Q000175:diagnosis / Q000453:epidemiology