Big Ten Sports Injury Reporting System 1987–1988

Introduction Surveys that collect information on injuries often focus on the single “most serious” event to help limit recall error and reduce survey length. However, this can mask less serious injuries and result in biased incidence estimates for specific injury subcategories. Methods Data from the 2002 Health Behaviour in School-aged Children (HBSC) survey and from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) were used to compare estimates of sports injury incidence in Canadian children. Results HBSC data indicate that 6.7% of children report sustaining a sports injury that required an emergency department (ED) visit. However, details were only collected on a child’s “most serious” injury, so children who had multiple injuries requiring an ED visit may have had sports injuries that went unreported. The rate of 6.7% can be seen to be an underestimate by as much as 4.3%. Corresponding CHIRPP surveillance data indicate an incidence of 9.9%. Potential masking bias is also highlighted in our analysis of injuries attended by other health care providers. Conclusion The “one most serious injury” line of questioning induces potentially substantial masking bias in the estimation of sports injury incidence, which limits researchers’ ability to quantify the burden of sports injury. Longer survey recall periods naturally lead to greater masking. The design of future surveys should take these issues into account. In order to accurately inform policy decisions and the direction of future research, researchers must be aware of these limitations.

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Time-to-Event Analyses: Return to Unrestricted Participation After Sport-Related Concussion in a Cohort of High School Athletes

Journal of Athletic Training ◽

10.4085/1062-6050-0150-20 ◽

2021 ◽

Author(s):

Tracey Covassin ◽

Abigail C. Bretzin ◽

Erica Beidler ◽

Jessica Wallace

Keyword(s):

High School ◽

Head Injury ◽

High School Student ◽

Student Athletes ◽

Reporting System ◽

Event Analysis ◽

Time To Event ◽

Injury Surveillance System ◽

Injury Reporting ◽

High School Athletic

Context Understanding time loss resulting from sport-related concussion (SRC) within individual sports allows high school athletic trainers to provide accurate and evidence-based clinical information. Currently, research regarding patterns of clinical recovery outcomes in high school student-athletes across sports is lacking. Objective To describe the time to authorized unrestricted return to participation (RTP) after SRC in a large cohort of high school student-athletes in a variety of sports using a time-to-event analysis. Design Descriptive epidemiology study. Setting Aggregate injury and player exposure data from the Michigan High School Athletic Association Head Injury Reporting System. Patients or Other Participants High school student-athletes. Main Outcome Measure(s) Dates for SRC injury events and authorized unrestricted RTP were entered into the Head Injury Reporting System for each case and were used to calculate time to unrestricted RTP. Survival analysis indicated the time to authorized RTP for males and females in weekly increments across sports and academic years. Separate Kaplan-Meier analyses adjusted for SRC cases with a history of concussion also identified the proportions of student-athletes who obtained authorized medical clearance in weekly increments. Results A total of 15 821 SRCs, 10 375 (65.6%) in males and 5446 (34.4%) in females, were reported during the 2015–2016 through 2018–2019 academic years. The median time to authorized unrestricted RTP was 11 days for all patients. Approximately 30% of concussed student-athletes were not cleared for unrestricted RTP by 14 days after their SRC diagnosis, with 13% taking longer than 21 days to return to unrestricted RTP after SRC. Conclusions The results from this multisite, state-based injury surveillance system indicated that it is not abnormal for high school student-athletes to take longer than 14 days to fully recover from an SRC. This information may be useful for educating high school student-athletes and sport stakeholders, normalizing SRC recovery trajectory perceptions, and establishing realistic RTP timeline expectations.

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Statistical Methods for Handling Observation Clustering in Sports Injury Surveillance

Journal of Athletic Training ◽

10.4085/1062-6050-438-18 ◽

2019 ◽

Vol 54 (11) ◽

pp. 1192-1196 ◽

Cited By ~ 2

Author(s):

Avinash Chandran ◽

Derek Brown ◽

Aliza K. Nedimyer ◽

Zachary Y. Kerr

Keyword(s):

Statistical Methods ◽

Analytical Methods ◽

Sports Injury ◽

Careful Consideration ◽

Multiple Injury ◽

Injury Surveillance ◽

Statistical Analyses ◽

Surveillance Data ◽

Time Loss ◽

Injury Reporting

Context Advances in sports injury-surveillance methods have made it possible to accommodate non–time-loss (NTL) injury reporting; however, the analysis of surveillance data now requires careful consideration of the nuances of NTL injury records. Background Injury-surveillance mechanisms that record NTL injuries are more likely to contain multiple injury records per athlete. These must be handled appropriately in statistical analyses to make methodologically sound inferences. Methods We simulated datasets of NTL injuries using varying degrees of observation clustering and compared the inferences made using traditional techniques with those made after accounting for clustering in computations of injury proportion ratios. Results Inappropriate handling of even moderate clustering resulted in flawed inferences in 10% to 12% of our simulations. We observed greater bias in our estimates as the degree of clustering increased. Conclusions We urge investigators to carefully consider observation clustering and adapt analytical methods to accommodate the evolving sophistication of surveillance.

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