Developing common demographic data elements to include in future editions of the SCAT and Child SCAT: a modified international Delphi study

Abstract

BackgroundThe Sport Concussion Assessment Tool (SCAT) and Child SCAT are the ‘gold standard’ assessment tools for a suspected sport-related concussion (SRC). A number of ‘modifiers’ (eg, previous history of concussion) of a SRC have been identified. These may influence how the SCAT/Child SCAT results should be interpreted.ObjectivesTo achieve consensus, via an international panel of SRC experts, on which athlete/player and parent/caregiver demographic variables should be considered for inclusion in future editions of the SCAT/Child SCAT respectively.MethodsA two-round modified Delphi technique, overseen by a steering committee, invited 41 panellists to achieve expert consensus (≥80% agreement). The first round utilised open questions to generate demographic variables; the second round used a five-point ordinal item to rank the importance of including each variable in future editions of the SCAT/Child SCAT.Results15 experts participated in at least one Delphi round. 29 athlete/player and eight parent/caregiver variables reached consensus for inclusion in the SCAT, whereas two parent/caregiver variables reached consensus for exclusion. 28 athlete/player and four parent/caregiver variables reached consensus for the Child SCAT, whereas two parent/caregiver variables reached consensus for exclusion. Key categories of variables included the following: concussion/sport details, personal medical conditions and family medical history.ConclusionThis study provides a list of athlete/player and parent/caregiver demographic variables that should be considered in future revisions of the SCAT/Child SCAT. By considering (and ultimately likely including) a wider and standard set of additional demographic variables, the Concussion in Sport experts will be able to provide clinicians and researchers with data that may enhance interpretation of the individual’s data and the building of larger datasets.

Patient Characteristics Predictive of Immediate and Delayed Word Recall Performance Following Adolescent Concussion

“…Furthermore, patient characteristics of age, sex, and presence of ADD/ADHD, in addition to timing of clinical presentation and concussion history, did not demonstrate an association with recall performance. Previous research has identified patient characteristics associated with performance on standardized concussion evaluations, and the results of our study contribute to this growing area of literature [13,14,15,16,17,23].…”

“…Consistent with existing literature, we hypothesized that specific demographic, injury, and clinical test characteristics, such as shorter time between injury and assessment, and presence of ADD/ADHD, would be associated with worse performance on immediate or delayed word recall testing. The performance associations identified in this study may contribute to ongoing considerations regarding the inclusion of specific data elements in future standardized concussion assessments [17].…”

“…Patient characteristics that may be associated with recall performance on the 10-word list for adolescents with concussion, such as age, sex, or symptom severity, remain unexplored. This gap in the literature is particularly important given that patient age, sex, symptom burden, and timing of clinical presentation [14] as well as the presence of a learning disorder or diagnosis of ADHD [13,15] may influence performance on a range of assessments post-concussion [7,[13][14][15][16][17]. Understanding the relationship between patient characteristics and recall performance can assist clinicians when interpreting memory test results and determining appropriate treatment decisions for patients recovering from concussion.…”

Kinetic chain revisited: consensus expert opinion on terminology, clinical reasoning, examination, and treatment in people with shoulder pain

“…3 Our study recruited 15 participants which is in the range of previous Delphi studies where 10-50 participants have been reported. 16,34,51,57,64,68 Importantly, based on the characteristics of our panel members including their clinical experience number of years using the KC concept and their highest professional degree (Table 1), its quality is considered high. This gives robustness and credibility to the results of the current study.…”

“…A priori consensus threshold of 70% was used in order to be more sensible and avoid missing possible items that might be of interest but it is lower than other similar Delphi studies. 56,57 There is currently no agreement in the literature about which is the "best" threshold (if any) to be used in Delphi studies. Importantly, different thresholds can produce different number of items retained at the end of the Delphi study.…”