@article{ref1,
title="Sport concussion assessment tool: baseline and clinical reference limits for concussion diagnosis and management in elite rugby union",
journal="Journal of science and medicine in sport",
year="2020",
author="Tucker, R. and Falvey, E. C. and Fuller, Gordon W. and Hislop, M. D. and Patricios, J. and Raftery, M.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: Rugby Union has adapted the Sports Concussion Assessment Tool (SCAT) into an abridged off-field concussion screen and the complete SCAT is used during diagnostic screens performed after head impact events. No firm guidelines exist as to what should be considered &quot;abnormal&quot; and warrant further evaluation. This study evaluates SCAT performances in 13,479 baseline SCAT assessments, and proposes clear reference limits for each sub-component of the SCAT5. Baseline reference limits are proposed to guide management of baseline testing by identifying abnormal sub-tests, enhancing the clinical validity of baseline screens, while clinical reference limits are identified to support concussion diagnosis when no baseline is available.   DESIGN: Cross sectional census sample.   METHODS: 13,479 baseline SCATs from 7565 elite male rugby players were evaluated. Baseline reference limits were identified for each sub-test as the sub-test result achieved by approximately 5% of the population, while clinical references limits corresponded to the sub-test score achieved by as close as possible to 50% of the cohort.   RESULTS: Players reported symptoms 35% (95% CI 1.29-1.42) more frequently during SCAT5 than SCAT3 baseline assessments (mean 1.4±2.7 vs 1.0±2.4). Ceiling effects were identified for many cognitive sub-tests within the SCAT. Baseline and Clinical reference limits corresponding to the worst performing 5th percentile and 50th percentile were described.   CONCLUSIONS: Targeted baseline re-testing should be repeated when abnormal sub-tests are identified according to proposed baseline reference limits, while a more conservative clinical reference limit supports concussion diagnosis during screens in diagnostic settings.<p /> <p>Language: en</p>",
language="en",
issn="1440-2440",
doi="10.1016/j.jsams.2020.07.006",
url="http://dx.doi.org/10.1016/j.jsams.2020.07.006"
}