Iverson, G L
Suicide and Chronic Traumatic Encephalopathy Journal Article
In: Journal of Neuropsychiatry & Clinical Neurosciences, vol. 28, no. 1, pp. 9–16, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Football/in [Injuries], *Suicide/px [Psychology], Athletic Injuries/di [Diagnosis], Athletic Injuries/ep [Epidemiology], Athletic Injuries/px [Psychology], Brain Injury, Chronic/di [Diagnosis], Chronic/ep [Epidemiology], Chronic/px [Psychology], Football/px [Psychology], Humans, Male, Risk Factors, Suicide/td [Trends]
@article{Iverson2016a,
title = {Suicide and Chronic Traumatic Encephalopathy},
author = {Iverson, G L},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neuropsychiatry \& Clinical Neurosciences},
volume = {28},
number = {1},
pages = {9--16},
abstract = {For nearly 80 years, suicidality was not considered to be a core clinical feature of chronic traumatic encephalopathy (CTE). In recent years, suicide has been widely cited as being associated with CTE, and now depression has been proposed to be one of three core diagnostic features alongside cognitive impairment and anger control problems. This evolution of the clinical features has been reinforced by thousands of media stories reporting a connection between mental health problems in former athletes and military veterans, repetitive neurotrauma, and CTE. At present, the science underlying the causal assumption between repetitive neurotrauma, depression, suicide, and the neuropathology believed to be unique to CTE is inconclusive. Epidemiological evidence indicates that former National Football League players, for example, are at lower, not greater, risk for suicide than men in the general population. This article aims to discuss the critical issues and literature relating to these possible relationships.},
keywords = {*Brain Injury, *Football/in [Injuries], *Suicide/px [Psychology], Athletic Injuries/di [Diagnosis], Athletic Injuries/ep [Epidemiology], Athletic Injuries/px [Psychology], Brain Injury, Chronic/di [Diagnosis], Chronic/ep [Epidemiology], Chronic/px [Psychology], Football/px [Psychology], Humans, Male, Risk Factors, Suicide/td [Trends]},
pubstate = {published},
tppubtype = {article}
}
Kasamatsu, T; Cleary, M; Bennett, J; Howard, K; McLeod, T V
Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 153–161, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires
@article{Kasamatsu2016a,
title = {Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer},
author = {Kasamatsu, T and Cleary, M and Bennett, J and Howard, K and McLeod, T V},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {153--161},
abstract = {CONTEXT: Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools. OBJECTIVE: To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 1124 secondary school ATs completed the survey (28.5% response rate). The majority of participants were employed full time (752/1114 [67.5%]) in public schools (911/1117 [81.6%]). MAIN OUTCOME MEASURE(S): School and AT employment characteristics, demographics, number of concussions evaluated annually, and perceptions of school professionals' familiarity with ATs' responsibilities were independent variables. RESULTS: Of the ATs, 44% reported having an existing return-to-learn policy. The strongest predictor of a return-to-learn policy was frequent communication with teachers after concussion (odds ratio = 1.5; 95% confidence interval = 1.2, 1.7). Most ATs recommended complete cognitive rest (eg, no reading, television; 492/1087 [45.3%]) or limited cognitive activity based upon symptoms (391/1087 [36.0%]). Common academic accommodations were postponed due dates (789/954 [82.7%]), rest breaks (765/954 [80.2%]), and partial attendance (740/954 [77.6%]). Athletic trainers self-reported as primary monitors of health (764/1037 [73.7%]) and academic progression (359/1011 [35.5%]). The strongest predictor of ATs' communication with school professionals was their perception of school professionals' understanding of ATs' roles. CONCLUSIONS: Overall, ATs followed best practices for cognitive rest and return to learn after concussion. Although ATs are central to the management of student-athletes' physical health after concussion, school professionals may be better suited to monitor academic progress. Increased communication between the AT and school professionals is recommended to monitor recovery and facilitate academic support for symptomatic student-athletes.},
keywords = {*Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Pham, H; Zemek, R
A 15-year-old rugby player with a head injury Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 187, no. 3, pp. 200–202, 2015.
BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Football/in [Injuries], Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ra [Radiography], Brain Concussion/rh [Rehabilitation], Brain Concussion/th [Therapy], Female, Glasgow Coma Scale, Humans, Physical Examination, Recovery of Function, Tomography, X-Ray Computed
@article{Pham2015,
title = {A 15-year-old rugby player with a head injury},
author = {Pham, H and Zemek, R},
year = {2015},
date = {2015-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {187},
number = {3},
pages = {200--202},
keywords = {*Brain Concussion/di [Diagnosis], *Football/in [Injuries], Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ra [Radiography], Brain Concussion/rh [Rehabilitation], Brain Concussion/th [Therapy], Female, Glasgow Coma Scale, Humans, Physical Examination, Recovery of Function, Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Pfaller, A Y; Rein, L E; McCrea, M A
Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: ANAM, Axon Sports, and ImPACT Journal Article
In: American Journal of Sports Medicine, vol. 43, no. 8, pp. 2018–2026, 2015.
Abstract | BibTeX | Tags: *Athletes/px [Psychology], *Neuropsychological Tests, Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/px [Psychology], Attention Deficit Disorder with Hyperactivity/co [, Brain Concussion/di [Diagnosis], Brain Concussion/px [Psychology], Female, Humans, intelligence, Male, Reproducibility of Results, Students/px [Psychology], Young Adult
@article{Nelson2015,
title = {Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: ANAM, Axon Sports, and ImPACT},
author = {Nelson, L D and Pfaller, A Y and Rein, L E and McCrea, M A},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Sports Medicine},
volume = {43},
number = {8},
pages = {2018--2026},
abstract = {BACKGROUND: Preseason baseline testing using computerized neurocognitive tests (CNTs) is increasingly performed on athletes. Adequate effort is critical to establish valid estimates of ability, but many users do not evaluate performance validity, and the conditions that affect validity are not well understood across the available CNTs. PURPOSE: To examine the rates and predictors of invalid baseline performance for 3 popular CNTs: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports, and Immediate Post-Concussion and Cognitive Testing (ImPACT). STUDY DESIGN: Controlled laboratory study. METHODS: High school and collegiate athletes (N = 2063) completed 2 of 3 CNTs each during preseason evaluations. All possible pairings were present across the sample, and the order of administration was randomized. Examiners provided 1-on-1, scripted pretest instructions, emphasizing the importance of good effort. Profile validity was determined by the manufacturers' standard criteria. RESULTS: The overall percentage of tests flagged as of questionable validity was lowest for ImPACT (2.7%) and higher for ANAM and Axon (10.7% and 11.3%, respectively). The majority of invalid baseline profiles were flagged as such because of failure on only 1 validity criterion. Several athlete and testing factors (eg, attention deficit hyperactivity disorder [ADHD], estimated general intellectual ability, administration order) predicted validity status for 1 or more CNTs. Considering only first CNT administrations and participants without ADHD and/or a learning disability (n = 1835) brought the rates of invalid baseline performances to 2.1%, 8.8%, and 7.0% for ImPACT, ANAM, and Axon, respectively. Invalid profiles on the Medical Symptom Validity Test (MSVT) were rare (1.8% of participants) and demonstrated poor correspondence to CNT validity outcomes. CONCLUSION: The validity criteria for these CNTs may not identify the same causes of invalidity or be equally sensitive to effort. The validity indicators may not be equally appropriate for some athletes (eg, those with neurodevelopmental disorders). CLINICAL RELEVANCE: The data suggest that athletes do not put forth widespread low effort or that some validity criteria are more sensitive to invalid performance than others. It is important for examiners to be aware of the conditions that maximize the quality of baseline assessments and to understand what sources of invalid performance are captured by the validity criteria that they obtain.Copyright © 2015 The Author(s).},
keywords = {*Athletes/px [Psychology], *Neuropsychological Tests, Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/px [Psychology], Attention Deficit Disorder with Hyperactivity/co [, Brain Concussion/di [Diagnosis], Brain Concussion/px [Psychology], Female, Humans, intelligence, Male, Reproducibility of Results, Students/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Biederman, J; Feinberg, L; Chan, J; Adeyemo, B O; Woodworth, K Y; Panis, W; McGrath, N; Bhatnagar, S; Spencer, T J; Uchida, M; Kenworthy, T; Grossman, R; Zafonte, R; Faraone, S V
Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes Journal Article
In: Journal of Nervous & Mental Disease, vol. 203, no. 11, pp. 813–819, 2015.
Abstract | BibTeX | Tags: *Athletes, *Athletic Injuries/ep [Epidemiology], *Attention Deficit Disorder with Hyperactivity/ep, *Brain Injuries/ep [Epidemiology], *Students, Adolescent, adult, Athletic Injuries/di [Diagnosis], Attention Deficit Disorder with Hyperactivity/di [, Brain Injuries/di [Diagnosis], Child, Female, Humans, Male, Risk Factors, Young Adult
@article{Biederman2015,
title = {Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes},
author = {Biederman, J and Feinberg, L and Chan, J and Adeyemo, B O and Woodworth, K Y and Panis, W and McGrath, N and Bhatnagar, S and Spencer, T J and Uchida, M and Kenworthy, T and Grossman, R and Zafonte, R and Faraone, S V},
year = {2015},
date = {2015-01-01},
journal = {Journal of Nervous \& Mental Disease},
volume = {203},
number = {11},
pages = {813--819},
abstract = {A recent meta-analysis documented a significant statistical association between mild traumatic brain injury (mTBI) and attention deficit hyperactivity disorder (ADHD) (Adeyemo et al., 2014), but the direction of this effect was unclear. In this study, we hypothesized that ADHD would be an antecedent risk factor for mTBI. Participants were student athletes ages 12 to 25 who had sustained a mTBI and Controls of similar age and sex selected from studies of youth with and without ADHD. Subjects were assessed for symptoms of ADHD, concussion severity, and cognitive function. mTBI subjects had a significantly higher rate of ADHD than Controls, and in all cases the age of onset of ADHD was before mTBI onset. mTBI+ADHD subjects also had more severe concussion symptoms (fatigue and poor concentration) than mTBI-ADHD subjects. These results support ADHD as an antecedent risk factor for mTBI in student athletes and that its presence complicates the course of mTBI.},
keywords = {*Athletes, *Athletic Injuries/ep [Epidemiology], *Attention Deficit Disorder with Hyperactivity/ep, *Brain Injuries/ep [Epidemiology], *Students, Adolescent, adult, Athletic Injuries/di [Diagnosis], Attention Deficit Disorder with Hyperactivity/di [, Brain Injuries/di [Diagnosis], Child, Female, Humans, Male, Risk Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Buckley, T A; Burdette, G; Kelly, K
Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives Journal Article
In: Journal of Athletic Training, vol. 50, no. 8, pp. 879–888, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires
@article{Buckley2015,
title = {Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives},
author = {Buckley, T A and Burdette, G and Kelly, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Athletic Training},
volume = {50},
number = {8},
pages = {879--888},
abstract = {CONTEXT: The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. OBJECTIVE: To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. MAIN OUTCOME MEASURE(S): The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. RESULTS: Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%},
keywords = {*Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Butcher, I; McHugh, G S; Lu, J; Steyerberg, E W; Hernandez, A V; Mushkudiani, N; Maas, A I; Marmarou, A; Murray, G D
Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study Journal Article
In: Journal of Neurotrauma, vol. 24, no. 2, pp. 281–286, 2007.
Abstract | BibTeX | Tags: *Brain Injuries/di [Diagnosis], *Brain Injuries/et [Etiology], Accidents, adult, Age Factors, Athletic Injuries/co [Complications], Athletic Injuries/di [Diagnosis], Databases, Factual, Glasgow Outcome Scale, Humans, middle aged, Predictive Value of Tests, Prognosis, violence
@article{Butcher2007,
title = {Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study},
author = {Butcher, I and McHugh, G S and Lu, J and Steyerberg, E W and Hernandez, A V and Mushkudiani, N and Maas, A I and Marmarou, A and Murray, G D},
year = {2007},
date = {2007-01-01},
journal = {Journal of Neurotrauma},
volume = {24},
number = {2},
pages = {281--286},
abstract = {We aimed to describe and quantify the relationship between cause of injury and final outcome following traumatic brain injury (TBI). Individual patient data (N = 8708) from eight therapeutic Phase III randomized clinical trials in moderate or severe TBI, and three TBI surveys were used to investigate the relationship between cause of injury and outcome, as assessed by the Glasgow Outcome Scale (GOS) at 6 months. Proportional odds methodology was applied to quantify the strength of the association and expressed as an odds ratio in a meta-analysis. Heterogeneity across studies was assessed and associations with other predictive factors explored. In a univariate analysis, a strong association between the cause of injury and long-term outcome in moderate to severe TBI patients was observed, with consistent results across the studies. Road traffic accidents (OR 0.66, 95% CI 0.60-0.73), assaults (OR 0.66, 95% CI 0.52-0.84), and injuries sustained during sporting or recreational activities (OR 0.45, 95% CI 0.28-0.71) were all associated with better outcomes than the reference category of falls. Falls were found to be associated with an older age and with a higher incidence of mass lesions. Following adjustment for age in the analysis, the relationship between cause of injury and outcome was lost.},
keywords = {*Brain Injuries/di [Diagnosis], *Brain Injuries/et [Etiology], Accidents, adult, Age Factors, Athletic Injuries/co [Complications], Athletic Injuries/di [Diagnosis], Databases, Factual, Glasgow Outcome Scale, Humans, middle aged, Predictive Value of Tests, Prognosis, violence},
pubstate = {published},
tppubtype = {article}
}
Iverson, G L
Suicide and Chronic Traumatic Encephalopathy Journal Article
In: Journal of Neuropsychiatry & Clinical Neurosciences, vol. 28, no. 1, pp. 9–16, 2016.
@article{Iverson2016a,
title = {Suicide and Chronic Traumatic Encephalopathy},
author = {Iverson, G L},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neuropsychiatry \& Clinical Neurosciences},
volume = {28},
number = {1},
pages = {9--16},
abstract = {For nearly 80 years, suicidality was not considered to be a core clinical feature of chronic traumatic encephalopathy (CTE). In recent years, suicide has been widely cited as being associated with CTE, and now depression has been proposed to be one of three core diagnostic features alongside cognitive impairment and anger control problems. This evolution of the clinical features has been reinforced by thousands of media stories reporting a connection between mental health problems in former athletes and military veterans, repetitive neurotrauma, and CTE. At present, the science underlying the causal assumption between repetitive neurotrauma, depression, suicide, and the neuropathology believed to be unique to CTE is inconclusive. Epidemiological evidence indicates that former National Football League players, for example, are at lower, not greater, risk for suicide than men in the general population. This article aims to discuss the critical issues and literature relating to these possible relationships.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Kasamatsu, T; Cleary, M; Bennett, J; Howard, K; McLeod, T V
Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 153–161, 2016.
@article{Kasamatsu2016a,
title = {Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer},
author = {Kasamatsu, T and Cleary, M and Bennett, J and Howard, K and McLeod, T V},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {153--161},
abstract = {CONTEXT: Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools. OBJECTIVE: To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 1124 secondary school ATs completed the survey (28.5% response rate). The majority of participants were employed full time (752/1114 [67.5%]) in public schools (911/1117 [81.6%]). MAIN OUTCOME MEASURE(S): School and AT employment characteristics, demographics, number of concussions evaluated annually, and perceptions of school professionals' familiarity with ATs' responsibilities were independent variables. RESULTS: Of the ATs, 44% reported having an existing return-to-learn policy. The strongest predictor of a return-to-learn policy was frequent communication with teachers after concussion (odds ratio = 1.5; 95% confidence interval = 1.2, 1.7). Most ATs recommended complete cognitive rest (eg, no reading, television; 492/1087 [45.3%]) or limited cognitive activity based upon symptoms (391/1087 [36.0%]). Common academic accommodations were postponed due dates (789/954 [82.7%]), rest breaks (765/954 [80.2%]), and partial attendance (740/954 [77.6%]). Athletic trainers self-reported as primary monitors of health (764/1037 [73.7%]) and academic progression (359/1011 [35.5%]). The strongest predictor of ATs' communication with school professionals was their perception of school professionals' understanding of ATs' roles. CONCLUSIONS: Overall, ATs followed best practices for cognitive rest and return to learn after concussion. Although ATs are central to the management of student-athletes' physical health after concussion, school professionals may be better suited to monitor academic progress. Increased communication between the AT and school professionals is recommended to monitor recovery and facilitate academic support for symptomatic student-athletes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Pham, H; Zemek, R
A 15-year-old rugby player with a head injury Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 187, no. 3, pp. 200–202, 2015.
@article{Pham2015,
title = {A 15-year-old rugby player with a head injury},
author = {Pham, H and Zemek, R},
year = {2015},
date = {2015-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {187},
number = {3},
pages = {200--202},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Pfaller, A Y; Rein, L E; McCrea, M A
Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: ANAM, Axon Sports, and ImPACT Journal Article
In: American Journal of Sports Medicine, vol. 43, no. 8, pp. 2018–2026, 2015.
@article{Nelson2015,
title = {Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: ANAM, Axon Sports, and ImPACT},
author = {Nelson, L D and Pfaller, A Y and Rein, L E and McCrea, M A},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Sports Medicine},
volume = {43},
number = {8},
pages = {2018--2026},
abstract = {BACKGROUND: Preseason baseline testing using computerized neurocognitive tests (CNTs) is increasingly performed on athletes. Adequate effort is critical to establish valid estimates of ability, but many users do not evaluate performance validity, and the conditions that affect validity are not well understood across the available CNTs. PURPOSE: To examine the rates and predictors of invalid baseline performance for 3 popular CNTs: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports, and Immediate Post-Concussion and Cognitive Testing (ImPACT). STUDY DESIGN: Controlled laboratory study. METHODS: High school and collegiate athletes (N = 2063) completed 2 of 3 CNTs each during preseason evaluations. All possible pairings were present across the sample, and the order of administration was randomized. Examiners provided 1-on-1, scripted pretest instructions, emphasizing the importance of good effort. Profile validity was determined by the manufacturers' standard criteria. RESULTS: The overall percentage of tests flagged as of questionable validity was lowest for ImPACT (2.7%) and higher for ANAM and Axon (10.7% and 11.3%, respectively). The majority of invalid baseline profiles were flagged as such because of failure on only 1 validity criterion. Several athlete and testing factors (eg, attention deficit hyperactivity disorder [ADHD], estimated general intellectual ability, administration order) predicted validity status for 1 or more CNTs. Considering only first CNT administrations and participants without ADHD and/or a learning disability (n = 1835) brought the rates of invalid baseline performances to 2.1%, 8.8%, and 7.0% for ImPACT, ANAM, and Axon, respectively. Invalid profiles on the Medical Symptom Validity Test (MSVT) were rare (1.8% of participants) and demonstrated poor correspondence to CNT validity outcomes. CONCLUSION: The validity criteria for these CNTs may not identify the same causes of invalidity or be equally sensitive to effort. The validity indicators may not be equally appropriate for some athletes (eg, those with neurodevelopmental disorders). CLINICAL RELEVANCE: The data suggest that athletes do not put forth widespread low effort or that some validity criteria are more sensitive to invalid performance than others. It is important for examiners to be aware of the conditions that maximize the quality of baseline assessments and to understand what sources of invalid performance are captured by the validity criteria that they obtain.Copyright © 2015 The Author(s).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Biederman, J; Feinberg, L; Chan, J; Adeyemo, B O; Woodworth, K Y; Panis, W; McGrath, N; Bhatnagar, S; Spencer, T J; Uchida, M; Kenworthy, T; Grossman, R; Zafonte, R; Faraone, S V
Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes Journal Article
In: Journal of Nervous & Mental Disease, vol. 203, no. 11, pp. 813–819, 2015.
@article{Biederman2015,
title = {Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes},
author = {Biederman, J and Feinberg, L and Chan, J and Adeyemo, B O and Woodworth, K Y and Panis, W and McGrath, N and Bhatnagar, S and Spencer, T J and Uchida, M and Kenworthy, T and Grossman, R and Zafonte, R and Faraone, S V},
year = {2015},
date = {2015-01-01},
journal = {Journal of Nervous \& Mental Disease},
volume = {203},
number = {11},
pages = {813--819},
abstract = {A recent meta-analysis documented a significant statistical association between mild traumatic brain injury (mTBI) and attention deficit hyperactivity disorder (ADHD) (Adeyemo et al., 2014), but the direction of this effect was unclear. In this study, we hypothesized that ADHD would be an antecedent risk factor for mTBI. Participants were student athletes ages 12 to 25 who had sustained a mTBI and Controls of similar age and sex selected from studies of youth with and without ADHD. Subjects were assessed for symptoms of ADHD, concussion severity, and cognitive function. mTBI subjects had a significantly higher rate of ADHD than Controls, and in all cases the age of onset of ADHD was before mTBI onset. mTBI+ADHD subjects also had more severe concussion symptoms (fatigue and poor concentration) than mTBI-ADHD subjects. These results support ADHD as an antecedent risk factor for mTBI in student athletes and that its presence complicates the course of mTBI.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Buckley, T A; Burdette, G; Kelly, K
Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives Journal Article
In: Journal of Athletic Training, vol. 50, no. 8, pp. 879–888, 2015.
@article{Buckley2015,
title = {Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives},
author = {Buckley, T A and Burdette, G and Kelly, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Athletic Training},
volume = {50},
number = {8},
pages = {879--888},
abstract = {CONTEXT: The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. OBJECTIVE: To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. MAIN OUTCOME MEASURE(S): The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. RESULTS: Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Butcher, I; McHugh, G S; Lu, J; Steyerberg, E W; Hernandez, A V; Mushkudiani, N; Maas, A I; Marmarou, A; Murray, G D
Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study Journal Article
In: Journal of Neurotrauma, vol. 24, no. 2, pp. 281–286, 2007.
@article{Butcher2007,
title = {Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study},
author = {Butcher, I and McHugh, G S and Lu, J and Steyerberg, E W and Hernandez, A V and Mushkudiani, N and Maas, A I and Marmarou, A and Murray, G D},
year = {2007},
date = {2007-01-01},
journal = {Journal of Neurotrauma},
volume = {24},
number = {2},
pages = {281--286},
abstract = {We aimed to describe and quantify the relationship between cause of injury and final outcome following traumatic brain injury (TBI). Individual patient data (N = 8708) from eight therapeutic Phase III randomized clinical trials in moderate or severe TBI, and three TBI surveys were used to investigate the relationship between cause of injury and outcome, as assessed by the Glasgow Outcome Scale (GOS) at 6 months. Proportional odds methodology was applied to quantify the strength of the association and expressed as an odds ratio in a meta-analysis. Heterogeneity across studies was assessed and associations with other predictive factors explored. In a univariate analysis, a strong association between the cause of injury and long-term outcome in moderate to severe TBI patients was observed, with consistent results across the studies. Road traffic accidents (OR 0.66, 95% CI 0.60-0.73), assaults (OR 0.66, 95% CI 0.52-0.84), and injuries sustained during sporting or recreational activities (OR 0.45, 95% CI 0.28-0.71) were all associated with better outcomes than the reference category of falls. Falls were found to be associated with an older age and with a higher incidence of mass lesions. Following adjustment for age in the analysis, the relationship between cause of injury and outcome was lost.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Iverson, G L
Suicide and Chronic Traumatic Encephalopathy Journal Article
In: Journal of Neuropsychiatry & Clinical Neurosciences, vol. 28, no. 1, pp. 9–16, 2016.
Abstract | BibTeX | Tags: *Brain Injury, *Football/in [Injuries], *Suicide/px [Psychology], Athletic Injuries/di [Diagnosis], Athletic Injuries/ep [Epidemiology], Athletic Injuries/px [Psychology], Brain Injury, Chronic/di [Diagnosis], Chronic/ep [Epidemiology], Chronic/px [Psychology], Football/px [Psychology], Humans, Male, Risk Factors, Suicide/td [Trends]
@article{Iverson2016a,
title = {Suicide and Chronic Traumatic Encephalopathy},
author = {Iverson, G L},
year = {2016},
date = {2016-01-01},
journal = {Journal of Neuropsychiatry \& Clinical Neurosciences},
volume = {28},
number = {1},
pages = {9--16},
abstract = {For nearly 80 years, suicidality was not considered to be a core clinical feature of chronic traumatic encephalopathy (CTE). In recent years, suicide has been widely cited as being associated with CTE, and now depression has been proposed to be one of three core diagnostic features alongside cognitive impairment and anger control problems. This evolution of the clinical features has been reinforced by thousands of media stories reporting a connection between mental health problems in former athletes and military veterans, repetitive neurotrauma, and CTE. At present, the science underlying the causal assumption between repetitive neurotrauma, depression, suicide, and the neuropathology believed to be unique to CTE is inconclusive. Epidemiological evidence indicates that former National Football League players, for example, are at lower, not greater, risk for suicide than men in the general population. This article aims to discuss the critical issues and literature relating to these possible relationships.},
keywords = {*Brain Injury, *Football/in [Injuries], *Suicide/px [Psychology], Athletic Injuries/di [Diagnosis], Athletic Injuries/ep [Epidemiology], Athletic Injuries/px [Psychology], Brain Injury, Chronic/di [Diagnosis], Chronic/ep [Epidemiology], Chronic/px [Psychology], Football/px [Psychology], Humans, Male, Risk Factors, Suicide/td [Trends]},
pubstate = {published},
tppubtype = {article}
}
Kasamatsu, T; Cleary, M; Bennett, J; Howard, K; McLeod, T V
Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer Journal Article
In: Journal of Athletic Training, vol. 51, no. 2, pp. 153–161, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires
@article{Kasamatsu2016a,
title = {Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer},
author = {Kasamatsu, T and Cleary, M and Bennett, J and Howard, K and McLeod, T V},
year = {2016},
date = {2016-01-01},
journal = {Journal of Athletic Training},
volume = {51},
number = {2},
pages = {153--161},
abstract = {CONTEXT: Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools. OBJECTIVE: To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: A total of 1124 secondary school ATs completed the survey (28.5% response rate). The majority of participants were employed full time (752/1114 [67.5%]) in public schools (911/1117 [81.6%]). MAIN OUTCOME MEASURE(S): School and AT employment characteristics, demographics, number of concussions evaluated annually, and perceptions of school professionals' familiarity with ATs' responsibilities were independent variables. RESULTS: Of the ATs, 44% reported having an existing return-to-learn policy. The strongest predictor of a return-to-learn policy was frequent communication with teachers after concussion (odds ratio = 1.5; 95% confidence interval = 1.2, 1.7). Most ATs recommended complete cognitive rest (eg, no reading, television; 492/1087 [45.3%]) or limited cognitive activity based upon symptoms (391/1087 [36.0%]). Common academic accommodations were postponed due dates (789/954 [82.7%]), rest breaks (765/954 [80.2%]), and partial attendance (740/954 [77.6%]). Athletic trainers self-reported as primary monitors of health (764/1037 [73.7%]) and academic progression (359/1011 [35.5%]). The strongest predictor of ATs' communication with school professionals was their perception of school professionals' understanding of ATs' roles. CONCLUSIONS: Overall, ATs followed best practices for cognitive rest and return to learn after concussion. Although ATs are central to the management of student-athletes' physical health after concussion, school professionals may be better suited to monitor academic progress. Increased communication between the AT and school professionals is recommended to monitor recovery and facilitate academic support for symptomatic student-athletes.},
keywords = {*Athletic Injuries/px [Psychology], *Brain Concussion/px [Psychology], *Interdisciplinary Communication, *Learning, *Physical Education and Training, Adolescent, Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], cognition, Cross-Sectional Studies, Faculty, Humans, Schools, Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Pham, H; Zemek, R
A 15-year-old rugby player with a head injury Journal Article
In: CMAJ Canadian Medical Association Journal, vol. 187, no. 3, pp. 200–202, 2015.
BibTeX | Tags: *Brain Concussion/di [Diagnosis], *Football/in [Injuries], Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ra [Radiography], Brain Concussion/rh [Rehabilitation], Brain Concussion/th [Therapy], Female, Glasgow Coma Scale, Humans, Physical Examination, Recovery of Function, Tomography, X-Ray Computed
@article{Pham2015,
title = {A 15-year-old rugby player with a head injury},
author = {Pham, H and Zemek, R},
year = {2015},
date = {2015-01-01},
journal = {CMAJ Canadian Medical Association Journal},
volume = {187},
number = {3},
pages = {200--202},
keywords = {*Brain Concussion/di [Diagnosis], *Football/in [Injuries], Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/rh [Rehabilitation], Brain Concussion/ra [Radiography], Brain Concussion/rh [Rehabilitation], Brain Concussion/th [Therapy], Female, Glasgow Coma Scale, Humans, Physical Examination, Recovery of Function, Tomography, X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Nelson, L D; Pfaller, A Y; Rein, L E; McCrea, M A
Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: ANAM, Axon Sports, and ImPACT Journal Article
In: American Journal of Sports Medicine, vol. 43, no. 8, pp. 2018–2026, 2015.
Abstract | BibTeX | Tags: *Athletes/px [Psychology], *Neuropsychological Tests, Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/px [Psychology], Attention Deficit Disorder with Hyperactivity/co [, Brain Concussion/di [Diagnosis], Brain Concussion/px [Psychology], Female, Humans, intelligence, Male, Reproducibility of Results, Students/px [Psychology], Young Adult
@article{Nelson2015,
title = {Rates and Predictors of Invalid Baseline Test Performance in High School and Collegiate Athletes for 3 Computerized Neurocognitive Tests: ANAM, Axon Sports, and ImPACT},
author = {Nelson, L D and Pfaller, A Y and Rein, L E and McCrea, M A},
year = {2015},
date = {2015-01-01},
journal = {American Journal of Sports Medicine},
volume = {43},
number = {8},
pages = {2018--2026},
abstract = {BACKGROUND: Preseason baseline testing using computerized neurocognitive tests (CNTs) is increasingly performed on athletes. Adequate effort is critical to establish valid estimates of ability, but many users do not evaluate performance validity, and the conditions that affect validity are not well understood across the available CNTs. PURPOSE: To examine the rates and predictors of invalid baseline performance for 3 popular CNTs: Automated Neuropsychological Assessment Metrics (ANAM), Axon Sports, and Immediate Post-Concussion and Cognitive Testing (ImPACT). STUDY DESIGN: Controlled laboratory study. METHODS: High school and collegiate athletes (N = 2063) completed 2 of 3 CNTs each during preseason evaluations. All possible pairings were present across the sample, and the order of administration was randomized. Examiners provided 1-on-1, scripted pretest instructions, emphasizing the importance of good effort. Profile validity was determined by the manufacturers' standard criteria. RESULTS: The overall percentage of tests flagged as of questionable validity was lowest for ImPACT (2.7%) and higher for ANAM and Axon (10.7% and 11.3%, respectively). The majority of invalid baseline profiles were flagged as such because of failure on only 1 validity criterion. Several athlete and testing factors (eg, attention deficit hyperactivity disorder [ADHD], estimated general intellectual ability, administration order) predicted validity status for 1 or more CNTs. Considering only first CNT administrations and participants without ADHD and/or a learning disability (n = 1835) brought the rates of invalid baseline performances to 2.1%, 8.8%, and 7.0% for ImPACT, ANAM, and Axon, respectively. Invalid profiles on the Medical Symptom Validity Test (MSVT) were rare (1.8% of participants) and demonstrated poor correspondence to CNT validity outcomes. CONCLUSION: The validity criteria for these CNTs may not identify the same causes of invalidity or be equally sensitive to effort. The validity indicators may not be equally appropriate for some athletes (eg, those with neurodevelopmental disorders). CLINICAL RELEVANCE: The data suggest that athletes do not put forth widespread low effort or that some validity criteria are more sensitive to invalid performance than others. It is important for examiners to be aware of the conditions that maximize the quality of baseline assessments and to understand what sources of invalid performance are captured by the validity criteria that they obtain.Copyright © 2015 The Author(s).},
keywords = {*Athletes/px [Psychology], *Neuropsychological Tests, Adolescent, Athletic Injuries/di [Diagnosis], Athletic Injuries/px [Psychology], Attention Deficit Disorder with Hyperactivity/co [, Brain Concussion/di [Diagnosis], Brain Concussion/px [Psychology], Female, Humans, intelligence, Male, Reproducibility of Results, Students/px [Psychology], Young Adult},
pubstate = {published},
tppubtype = {article}
}
Biederman, J; Feinberg, L; Chan, J; Adeyemo, B O; Woodworth, K Y; Panis, W; McGrath, N; Bhatnagar, S; Spencer, T J; Uchida, M; Kenworthy, T; Grossman, R; Zafonte, R; Faraone, S V
Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes Journal Article
In: Journal of Nervous & Mental Disease, vol. 203, no. 11, pp. 813–819, 2015.
Abstract | BibTeX | Tags: *Athletes, *Athletic Injuries/ep [Epidemiology], *Attention Deficit Disorder with Hyperactivity/ep, *Brain Injuries/ep [Epidemiology], *Students, Adolescent, adult, Athletic Injuries/di [Diagnosis], Attention Deficit Disorder with Hyperactivity/di [, Brain Injuries/di [Diagnosis], Child, Female, Humans, Male, Risk Factors, Young Adult
@article{Biederman2015,
title = {Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes},
author = {Biederman, J and Feinberg, L and Chan, J and Adeyemo, B O and Woodworth, K Y and Panis, W and McGrath, N and Bhatnagar, S and Spencer, T J and Uchida, M and Kenworthy, T and Grossman, R and Zafonte, R and Faraone, S V},
year = {2015},
date = {2015-01-01},
journal = {Journal of Nervous \& Mental Disease},
volume = {203},
number = {11},
pages = {813--819},
abstract = {A recent meta-analysis documented a significant statistical association between mild traumatic brain injury (mTBI) and attention deficit hyperactivity disorder (ADHD) (Adeyemo et al., 2014), but the direction of this effect was unclear. In this study, we hypothesized that ADHD would be an antecedent risk factor for mTBI. Participants were student athletes ages 12 to 25 who had sustained a mTBI and Controls of similar age and sex selected from studies of youth with and without ADHD. Subjects were assessed for symptoms of ADHD, concussion severity, and cognitive function. mTBI subjects had a significantly higher rate of ADHD than Controls, and in all cases the age of onset of ADHD was before mTBI onset. mTBI+ADHD subjects also had more severe concussion symptoms (fatigue and poor concentration) than mTBI-ADHD subjects. These results support ADHD as an antecedent risk factor for mTBI in student athletes and that its presence complicates the course of mTBI.},
keywords = {*Athletes, *Athletic Injuries/ep [Epidemiology], *Attention Deficit Disorder with Hyperactivity/ep, *Brain Injuries/ep [Epidemiology], *Students, Adolescent, adult, Athletic Injuries/di [Diagnosis], Attention Deficit Disorder with Hyperactivity/di [, Brain Injuries/di [Diagnosis], Child, Female, Humans, Male, Risk Factors, Young Adult},
pubstate = {published},
tppubtype = {article}
}
Buckley, T A; Burdette, G; Kelly, K
Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives Journal Article
In: Journal of Athletic Training, vol. 50, no. 8, pp. 879–888, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires
@article{Buckley2015,
title = {Concussion-Management Practice Patterns of National Collegiate Athletic Association Division II and III Athletic Trainers: How the Other Half Lives},
author = {Buckley, T A and Burdette, G and Kelly, K},
year = {2015},
date = {2015-01-01},
journal = {Journal of Athletic Training},
volume = {50},
number = {8},
pages = {879--888},
abstract = {CONTEXT: The National Collegiate Athletic Association (NCAA) has published concussion-management practice guidelines consistent with recent position and consensus statements. Whereas NCAA Division I athletic trainers appear highly compliant, little is known about the concussion-management practice patterns of athletic trainers at smaller institutions where staffing and resources may be limited. OBJECTIVE: To descriptively define the concussion-management practice patterns of NCAA Division II and III athletic trainers. DESIGN: Cross-sectional study. SETTING: Web-based questionnaire. PATIENTS OR OTHER PARTICIPANTS: A total of 755 respondents (response rate = 40.2%) from NCAA Division II and Division III institutions. MAIN OUTCOME MEASURE(S): The primary outcome measures were the rate of multifaceted concussion-assessment techniques, defined as 3 or more assessments; the specific practice patterns of each assessment battery; and tests used during a clinical examination. RESULTS: Most respondents indicated using a multifaceted assessment during acute assessment (Division II = 76.9%},
keywords = {*Athletic Injuries/th [Therapy], *Brain Concussion/th [Therapy], *Sports/ph [Physiology], Athletic Injuries/di [Diagnosis], Brain Concussion/di [Diagnosis], Cross-Sectional Studies, Female, Humans, Male, Neuropsychological Tests, Physicians', Practice Guidelines as Topic, Practice Patterns, Return to Sport/ph [Physiology], Sports Medicine/mt [Methods], Surveys and Questionnaires},
pubstate = {published},
tppubtype = {article}
}
Butcher, I; McHugh, G S; Lu, J; Steyerberg, E W; Hernandez, A V; Mushkudiani, N; Maas, A I; Marmarou, A; Murray, G D
Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study Journal Article
In: Journal of Neurotrauma, vol. 24, no. 2, pp. 281–286, 2007.
Abstract | BibTeX | Tags: *Brain Injuries/di [Diagnosis], *Brain Injuries/et [Etiology], Accidents, adult, Age Factors, Athletic Injuries/co [Complications], Athletic Injuries/di [Diagnosis], Databases, Factual, Glasgow Outcome Scale, Humans, middle aged, Predictive Value of Tests, Prognosis, violence
@article{Butcher2007,
title = {Prognostic value of cause of injury in traumatic brain injury: results from the IMPACT study},
author = {Butcher, I and McHugh, G S and Lu, J and Steyerberg, E W and Hernandez, A V and Mushkudiani, N and Maas, A I and Marmarou, A and Murray, G D},
year = {2007},
date = {2007-01-01},
journal = {Journal of Neurotrauma},
volume = {24},
number = {2},
pages = {281--286},
abstract = {We aimed to describe and quantify the relationship between cause of injury and final outcome following traumatic brain injury (TBI). Individual patient data (N = 8708) from eight therapeutic Phase III randomized clinical trials in moderate or severe TBI, and three TBI surveys were used to investigate the relationship between cause of injury and outcome, as assessed by the Glasgow Outcome Scale (GOS) at 6 months. Proportional odds methodology was applied to quantify the strength of the association and expressed as an odds ratio in a meta-analysis. Heterogeneity across studies was assessed and associations with other predictive factors explored. In a univariate analysis, a strong association between the cause of injury and long-term outcome in moderate to severe TBI patients was observed, with consistent results across the studies. Road traffic accidents (OR 0.66, 95% CI 0.60-0.73), assaults (OR 0.66, 95% CI 0.52-0.84), and injuries sustained during sporting or recreational activities (OR 0.45, 95% CI 0.28-0.71) were all associated with better outcomes than the reference category of falls. Falls were found to be associated with an older age and with a higher incidence of mass lesions. Following adjustment for age in the analysis, the relationship between cause of injury and outcome was lost.},
keywords = {*Brain Injuries/di [Diagnosis], *Brain Injuries/et [Etiology], Accidents, adult, Age Factors, Athletic Injuries/co [Complications], Athletic Injuries/di [Diagnosis], Databases, Factual, Glasgow Outcome Scale, Humans, middle aged, Predictive Value of Tests, Prognosis, violence},
pubstate = {published},
tppubtype = {article}
}