@article{ref1,
title="The sensitivity and specificity of clinical measures of sport concussion: three tests are better than one",
journal="BMJ open sport and exercise medicine",
year="2016",
author="Resch, Jacob E. and Brown, Cathleen N. and Schmidt, Julianne and Macciocchi, Stephen N. and Blueitt, Damond and Cullum, C. Munro and Ferrara, Michael S.",
volume="2",
number="1",
pages="e000012-e000012",
abstract="CONTEXT: A battery of clinical measures of neurocognition, balance and symptoms has been recommended for the management of sport concussion (SC) but is based on variable evidence. <br><br>OBJECTIVE: To examine the sensitivity and specificity of a battery of tests to assess SC in college athletes. <br><br>DESIGN: Cross-sectional. SETTING: Research laboratory. PATIENTS OR OTHER PARTICIPANTS: Division 1 athletes diagnosed with a SC (n=40) who were 20.2±1.60 years of age and 180.5±11.12 cm tall and healthy athletes (n=40) who were 19.0±0.93 years of age and 179.1±11.39 cm tall were enrolled. INTERVENTIONS: Participants were administered Immediate Postconcussion Assessment and Cognitive Test (ImPACT), the Sensory Organization Test (SOT) and the Revised Head Injury Scale (HIS-r) prior to and up to 24 h following injury between the 2004 and 2014 sport seasons. Sensitivity and specificity were calculated using predictive discriminant analyses (PDA) and clinical interpretation guidelines. MAIN OUTCOME MEASURES: Outcome measures included baseline and postinjury ImPACT, SOT and HIS-r composite scores. <br><br>RESULTS: Using PDA, each clinical measure's sensitivity ranged from 55.0% to 77.5% and specificity ranged from 52.5% to 100%. The test battery possessed a sensitivity and specificity of 80.0% and 100%, respectively. Using clinical interpretation guidelines, sensitivity ranged from 55% to 97.5% individually, and 100% when combined. <br><br>CONCLUSIONS: Our results support a multidimensional approach to assess SC in college athletes which correctly identified 80-100% of concussed participants as injured. When each test was evaluated separately, up to 47.5% of our sample was misclassified. Caution is warranted when using singular measures to manage SC.<p /> <p>Language: en</p>",
language="en",
issn="2055-7647",
doi="10.1136/bmjsem-2015-000012",
url="http://dx.doi.org/10.1136/bmjsem-2015-000012"
}