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Diagnostic Utility of New SCAT5 Neurological Screen Sub-tests.

Gordon Ward Fuller1, John Miles2, Ross Tucker3

  • 1Centre for Urgent and Emergency Care Research, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. g.fuller@sheffield.ac.uk.

Sports Medicine - Open
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PubMed
Summary

The new rapid neurological screen subtests in the Sports Concussion Assessment Tool 5 (SCAT5) showed limited diagnostic value for elite rugby players. These subtests did not improve concussion screening beyond existing SCAT5 components.

Keywords:
Brain ConcussionDiagnostic accuracyRugbySCAT5Screening

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Area of Science:

  • Sports Medicine
  • Neurology
  • Athletic Training

Background:

  • The Sports Concussion Assessment Tool (SCAT) is crucial for screening concussions in elite sports.
  • The SCAT5 introduced a rapid neurological screen with subtests for comprehension, passive neck movement, and diplopia.
  • This study aimed to determine the diagnostic value of these new SCAT5 subtests.

Purpose of the Study:

  • To evaluate the diagnostic utility of the SCAT5's rapid neurological screen subtests.
  • To assess the sensitivity and specificity of comprehension, passive neck movement, and diplopia subtests in elite rugby players.
  • To determine if these new subtests add value beyond existing SCAT5 components for concussion screening.

Main Methods:

  • A prospective cohort study was conducted in the Pro14 elite Rugby Union competition (September 2018 - January 2020).
  • The SCAT5 was administered by team doctors to players undergoing off-field concussion screening.
  • Sensitivity, specificity, and diagnostic accuracy were analyzed, with final concussion diagnosis as the reference standard (48-hour clinical assessment).

Main Results:

  • Ninety-three players were included in the study.
  • The comprehension, passive neck movement, and diplopia subtests demonstrated low sensitivity (0%, 8%, 5%) and high specificity (90%, 91%, 97%).
  • No players exhibited abnormalities in these subtests without concurrent issues in other SCAT5 components.

Conclusions:

  • The new SCAT5 neurological screen subtests are frequently normal in players undergoing off-field concussion screening.
  • These subtests appear to lack significant diagnostic utility when used in conjunction with other SCAT5 components.
  • Current SCAT5 subtests may be sufficient for effective concussion screening in elite athletes.