Reported Symptoms Most Sensitive Indicator of Concussion

10-word Standardized Assessment of Concussion has limited utility
concussion head injury
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Medically Reviewed By:
Meeta Shah, M.D.

WEDNESDAY, June 26, 2024 (HealthDay News) -- Reported symptoms are a more accurate indicator of concussion than the 10-word component Standardized Assessment of Concussion (SAC), according to a study published online June 11 in JAMA Network Open.

Kimberly G. Harmon, M.D., from the University of Washington in Seattle, and colleagues assessed the diagnostic accuracy of components of the Sports Concussion Assessment Tool-5 using data from 92 National Collegiate Athletic Association Division I athletes (any sport from four universities) with concussion and 92 matched athletes without concussion.

The researchers found that the diagnostic utility was considered excellent for symptom score (area under the receiver operating characteristic curve [AUC], 0.93) and symptom severity score (AUC, 0.94). A two-point increase on the symptom score was associated with a sensitivity of 86 percent, specificity of 80 percent, and positive predictive value of 81 percent. Poor to fair diagnostic utility was seen with the total SAC score (AUC, 0.70), with 45 percent of athletes with concussion having a total SAC score at or above their baseline score (i.e., within normal limits). For immediate memory and delayed recall, the diagnostic utility was poor to fair (AUC, 0.68 and 0.69, respectively) and not useful for orientation (AUC, 0.49) and concentration (AUC, 0.52). Test-retest reliability was fair for total SAC, and poor for immediate memory and delayed recall, orientation, and concentration.

"These findings suggest that understanding the properties of the SAC is important when making the diagnosis of concussion," the authors write.

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