Stephen J C Hearps1, Michael Takagi1,2, Franz E Babl3,4,5, Silvia Bressan1,6, Katherine Truss1,2, Gavin A Davis1, Celia Godfrey1, Cathriona Clarke1, Melissa Doyle1,2, Vanessa Rausa1,2, Kevin Dunne1,4,7, Vicki Anderson1,2,4,8. 1. Murdoch Childrens Research Institute, Melbourne, Victoria, Australia. 2. Melbourne School of Psychological Sciences and. 3. Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; franz.babl@rch.org.au. 4. Department of Paediatrics, University of Melbourne, Victoria, Australia. 5. Emergency Department. 6. Department of Women's and Children's Health, University of Padova, Padova, Italy. 7. Department of Rehabilitation Medicine, and. 8. Psychology Service, Royal Children's Hospital, Melbourne, Victoria, Australia; and.
Abstract
BACKGROUND: A reliable, developmentally appropriate and standardized method for assessing postconcussive symptoms (PCS) is essential to accurately determine recovery postconcussion and to effectively manage return to normal activities. The aim of this study was to develop an evidence-based, psychometrically validated approach to determining clinically useful cutoff scores by using a commonly administered PCS measure. METHODS: The current study was a prospective, longitudinal observational study conducted between July 2013 and November of 2015 at a statewide tertiary pediatric hospital. Participants were 120 children (5-18 years of age) presenting to the emergency department with a concussion within 48 hours of injury. PCS were assessed by using the Postconcussion Symptom Inventory (PCSI), acutely, 1 to 4 days postinjury and 2 weeks postinjury. Using comprehensive clinical assessment as gold standard, we assessed the clinical cutoff discrimination ability of PCSI at 2 weeks postinjury by using published approaches, and then varying each approach to optimize their discrimination ability. RESULTS: Existing and potential clinical cutoff scores were explored in predicting delayed recovery. Receiver operating characteristic curve results returned acceptable discrimination and sensitivity when PCSI items increased in severity from preinjury by 1 or more. Compared with a published cutoff score being 3+ items with increased severity, the current study suggests a more stringent cutoff requirement of 2+ is better able to accurately classify symptomatic children. CONCLUSIONS: This study provides the first validated index (2+ items, 1+ severity) of concussion recovery for children and youth. Further studies in more varied samples are needed to establish the effectiveness of this method.
BACKGROUND: A reliable, developmentally appropriate and standardized method for assessing postconcussive symptoms (PCS) is essential to accurately determine recovery postconcussion and to effectively manage return to normal activities. The aim of this study was to develop an evidence-based, psychometrically validated approach to determining clinically useful cutoff scores by using a commonly administered PCS measure. METHODS: The current study was a prospective, longitudinal observational study conducted between July 2013 and November of 2015 at a statewide tertiary pediatric hospital. Participants were 120 children (5-18 years of age) presenting to the emergency department with a concussion within 48 hours of injury. PCS were assessed by using the Postconcussion Symptom Inventory (PCSI), acutely, 1 to 4 days postinjury and 2 weeks postinjury. Using comprehensive clinical assessment as gold standard, we assessed the clinical cutoff discrimination ability of PCSI at 2 weeks postinjury by using published approaches, and then varying each approach to optimize their discrimination ability. RESULTS: Existing and potential clinical cutoff scores were explored in predicting delayed recovery. Receiver operating characteristic curve results returned acceptable discrimination and sensitivity when PCSI items increased in severity from preinjury by 1 or more. Compared with a published cutoff score being 3+ items with increased severity, the current study suggests a more stringent cutoff requirement of 2+ is better able to accurately classify symptomatic children. CONCLUSIONS: This study provides the first validated index (2+ items, 1+ severity) of concussion recovery for children and youth. Further studies in more varied samples are needed to establish the effectiveness of this method.
Authors: Gavin A Davis; Vanessa C Rausa; Franz E Babl; Katie Davies; Michael Takagi; Alison Crichton; Audrey McKinlay; Nicholas Anderson; Stephen Jc Hearps; Cathriona Clarke; Remy Pugh; Kevin Dunne; Peter Barnett; Vicki Anderson Journal: Concussion Date: 2020-06-10
Authors: Andrew R Mayer; David D Stephenson; Andrew B Dodd; Cidney R Robertson-Benta; Sharvani Pabbathi Reddy; Nicholas A Shaff; Keith Owen Yeates; Harm J van der Horn; Christopher J Wertz; Grace Park; Scott J Oglesbee; Edward J Bedrick; Richard A Campbell; John P Phillips; Davin K Quinn Journal: J Neurotrauma Date: 2020-03-12 Impact factor: 5.269
Authors: Jesse S Shapiro; Michael Takagi; Tim Silk; Nicholas Anderson; Cathriona Clarke; Gavin A Davis; Stephen J C Hearps; Vera Ignjatovic; Vanessa Rausa; Marc L Seal; Franz E Babl; Vicki Anderson Journal: J Neurotrauma Date: 2021-07-30 Impact factor: 4.869
Authors: Karen M Barlow; Kartik Iyer; Tingting Yan; Alex Scurfield; Helen Carlson; Yang Wang Journal: J Neurotrauma Date: 2021-02-03 Impact factor: 4.869
Authors: Vicki Anderson; Vanessa C Rausa; Nicholas Anderson; Georgia Parkin; Cathriona Clarke; Katie Davies; Audrey McKinlay; Ali Crichton; Gavin A Davis; Kim Dalziel; Kevin Dunne; Peter Barnett; Stephen Jc Hearps; Michael Takagi; Franz E Babl Journal: BMJ Open Date: 2021-02-11 Impact factor: 2.692
Authors: Benjamin L Brett; Andrew W Kuhn; Aaron M Yengo-Kahn; Zachary Y Kerr; Christopher M Bonfield; Gary S Solomon; Scott L Zuckerman Journal: Sports Med Open Date: 2018-01-31
Authors: Cathriona Clarke; Vicki Anderson; Franz E Babl; Vanessa C Rausa; Gavin A Davis; Peter Barnett; Ali Crichton; Michael Takagi; Stephen J C Hearps; Katie Davies; Audrey McKinlay; Nicholas Anderson; Vivian Kwan; Sanji Kanagalingam; Gabi Ceregra; Anita Petris; Simone Darling; Patrick Clifton; Peter Harcourt Journal: Ann Transl Med Date: 2020-05