Pediatric Providers’ Self-Reported Knowledge, Practices, and Attitudes About Concussion

Zonfrillo, Mark R.; Master, Christina L.; Grady, Matthew F.; Winston, Flaura Koplin; Callahan, James M.; Arbogast, Kristy B.

doi:10.1542/peds.2012-1431

Cited by 119 publications

(115 citation statements)

References 27 publications

Supporting

Mentioning

106

Contrasting

Order By: Relevance

“…Doctors of chiropractic primarily referred the patient to a neurologist. This correlates with Zonfrillo et al, 25 who reported on pediatric providers' self-reported knowledge of concussion. They reported that the majority of PCPs referred concussion patients to specialists because of their lack of comfort in managing concussions.…”

Section: Discussionsupporting

confidence: 86%

“…Previous studies reported inconsistent provider actions and insufficient training of pediatricians and emergency room physicians to adequately recognize, diagnose, and treat TBI. 25 There is a reported lack of awareness of concussion guidelines among pediatricians. 26 Other studies have reported the deficient TBI knowledge of coaches, 27,28 medical students, 29 emergency physicians, and family medical physicians.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Survey of Primary Contact Medical and Chiropractic Clinicians on Self-Reported Knowledge and Recognition of Mild Traumatic Brain Injuries: A Pilot Study

Taylor

Ponce²,

Dyess

2017

Journal of Chiropractic Medicine

View full text Add to dashboard Cite

Objective: The purpose of this study was to assess the self-reported knowledge of concussion recognition and treatment with first-contact family medical and chiropractic practitioners by means of a pilot study of the need, construct validity, and feasibility for further investigation of mild traumatic brain injury (MTBI) knowledge base. Methods: Two hundred forty-eight practicing chiropractic and 120 medical physicians in the south and northeastern sections of the United States were contacted by e-mail, telephone, and postal mail to answer an 18-item survey on knowledge, diagnosis, and common practice with respect to traumatic brain injury patients. Descriptive analysis was used to assess common trends. Results: Twenty-three chiropractic and 11 medical primary care practitioners returned completed surveys, making this a low-power pilot study. The majority claimed confidence in diagnosis of MTBI, but a lack of knowledge of many of the assessment tools and the international guidelines. Chiropractic and medical clinicians revealed similar competencies and differing deficiencies. Both groups admitted infrequent diagnosis of MTBI in practice. There was recognition of major TBI signs, but lack of recognition or inquiry for subtle MTBI signs. Conclusions: There is a need and feasibility for further study of the knowledge transfer to the chiropractic physician with a larger population. These findings correlate with similar medical practitioner studies, and may also support previous findings of underreporting of the prevalence of MTBI. The survey instrument appears to provide valid data on knowledge of MTBIs, with some modifications. (J Chiropr Med 2017;16:19-30)

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Survey of Primary Contact Medical and Chiropractic Clinicians on Self-Reported Knowledge and Recognition of Mild Traumatic Brain Injuries: A Pilot Study

Taylor

Ponce²,

Dyess

2017

Journal of Chiropractic Medicine

View full text Add to dashboard Cite

show abstract

“…Recently, Zonfrillo et al examined the self-reported knowledge and attitudes of 145 pediatricians and pediatric emergency physicians affiliated with a single institution at an urban, academic, tertiary-care centre in the United States, and reported that inadequate knowledge existed of pediatric concussion diagnosis and initial management. 41 Boggild and Tator reported that gaps in general knowledge of concussion (e.g., concussion definition, signs/symptoms, initial management, and sequelae) existed in a survey of graduating medical students and postgraduate trainees in neurology and neurosurgery. 42 Lebrun et al found that family physicians in Alberta and North Dakota rarely recommended cognitive rest (47.5% and 28%, respectively), despite existing guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…Zonfrillo et al examined the barriers to providing education to families following a pediatric concussion across pediatric providers at the Children's Hospital of Philadelphia, but they did not describe the practice variation of cognitive rest instructions provided. 41 The development of our questionnaire was systematic, and it strengthened by involving a group of experts from various fields.…”

Section: Discussionmentioning

confidence: 99%

Canadian pediatric emergency physician knowledge of concussion diagnosis and initial management

Zemek

Eady

Farion

et al. 2015

CJEM

View full text Add to dashboard Cite

Introduction: The diagnosis of concussion is a critical step in the appropriate management of patients following minor head trauma. The authors hypothesized that wide practice variation exists among pediatric emergency medicine physicians in the application of physical and cognitive rest recommendations following an acute concussion. Methods: The authors developed a 35-item questionnaire incorporating case vignettes to examine pediatric emergency physician knowledge of concussion diagnosis, understanding of initial management using return-to-play/school/work guidelines, use of existing concussion protocols, and perceived barriers to protocol use. Using a modified Dillman technique, the authors distributed an online survey to members of Pediatric Emergency Research Canada, a national association of pediatric emergency physicians. Results: Of 176 potential participants, 115 (65%) responded to the questionnaire, 89% (95% confidence interval [CI]: 0.81, 0.93) of whom reported having diagnosed 20 or more concussions annually. Although 90% (95% CI: 0.83, 0.94) of respondents adequately diagnosed concussion, only 64% (95% CI: 0.54, 0.72) correctly applied graduated return-to-play guidelines. Cognitive rest recommendations were also frequently limited: 40% (95% CI: 0.31, 0.49) did not recommend school absence, 30% (95% CI: 0.22, 0.39) did not recommend schoolwork reduction, and 35% (95% CI: 0.27, 0.45) did not recommend limiting screen time. Eighty percent (95% CI: 0.72, 0.87) of respondents reported having used guidelines frequently or always to guide clinical decisions regarding concussion. Conclusion: Despite a proficiency in the diagnosis of concussion, pediatric emergency physicians exhibit wide variation in recommending the graduated return to play and cognitive rest following concussion.

show abstract

“…55,58,59,[69][70][71] Pediatricians and other primary care providers often manage youth after mTBI, although many do not feel they have adequate training or the tools to care for these patients. 72 Primary care management of mTBI is complicated further by the present findings. A subset of children seen for persistent complaints after mTBI display noncredible test performance and are apt to be exaggerating or feigning some of their symptoms.…”

Section: Discussionmentioning

confidence: 79%

Postconcussive Symptom Exaggeration After Pediatric Mild Traumatic Brain Injury

Kirkwood¹,

Peterson²,

Connery³

et al. 2014

Pediatrics

View full text Add to dashboard Cite

show abstract

Pediatric Providers’ Self-Reported Knowledge, Practices, and Attitudes About Concussion

Cited by 119 publications

References 27 publications

Survey of Primary Contact Medical and Chiropractic Clinicians on Self-Reported Knowledge and Recognition of Mild Traumatic Brain Injuries: A Pilot Study

Survey of Primary Contact Medical and Chiropractic Clinicians on Self-Reported Knowledge and Recognition of Mild Traumatic Brain Injuries: A Pilot Study

Canadian pediatric emergency physician knowledge of concussion diagnosis and initial management

Postconcussive Symptom Exaggeration After Pediatric Mild Traumatic Brain Injury

Contact Info

Product

Resources

About