The Sport Concussion Assessment Tool: a systematic review

OBJECTIVE Over the last 2 decades, sport-related concussion (SRC) has garnered significant attention. Even with increased awareness and athlete education, sideline recognition and real-time diagnosis remain crucial. The need for an objective and standardized assessment of concussion led to the eventual development of the Sport Concussion Assessment Tool (SCAT) during the Second International Conference on Concussion in Sport in 2004, which is now in its third iteration (SCAT3). In an effort to update our understanding of the most well-known sideline concussion assessment, the authors conducted a systematic review of the SCAT and the evidence supporting its use to date. METHODS English-language titles and abstracts published between 1995 and October 2015 were searched systematically across 4 electronic databases and a review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines adapted for the review of a heterogeneous collection of study designs. Peer-reviewed journal articles were included if they reported quantitative data on any iteration of the SCAT, Standardized Assessment of Concussion (SAC), or modified Balance Error Scoring System (mBESS) data at baseline or following concussion in an exclusively athlete population with any portion older than 13 years of age. Studies that included nonathletes, only children less than 13 years old, exclusively BESS data, exclusively symptom scale data, or a non–SCAT-related assessment were excluded. RESULTS The database search process yielded 549 abstracts, and 105 full-text articles were reviewed with 36 meeting criteria for inclusion. Nineteen studies were associated with the SAC, 1 was associated with the mBESS exclusively, and 16 studies were associated with a full iteration of the SCAT. The majority of these studies (56%) were prospective cohort studies. Male football players were the most common athletes studied. An analysis of the studies focused on baseline differences associated with age, sex, concussion history, and the ability to detect an SRC. CONCLUSIONS Looking toward the upcoming Concussion in Sport Group meeting in fall 2016, one may expect further revision to the SCAT3. However, based on this systematic review, the authors propose further, in-depth study of an already comprehensive concussion test, with acute, diagnostic, as well as long-term use.

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Equity considerations in outcome measures of the HIV pre-exposure prophylaxis care continuum in high-income countries: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2020-040701 ◽

2021 ◽

Vol 11 (2) ◽

pp. e040701

Author(s):

Melissa Cabecinha ◽

Danielle Solomon ◽

Greta Rait ◽

John Saunders ◽

Hamish Mohammed ◽

...

Keyword(s):

Systematic Review ◽

English Language ◽

Outcome Measure ◽

Assessment Tool ◽

Public Health Practice ◽

Risk Groups ◽

Care Continuum ◽

Quantitative Studies ◽

Prep Implementation ◽

Exposure Prophylaxis

IntroductionHIV pre-exposure prophylaxis (PrEP) is an effective intervention to reduce acquisition of HIV. PrEP provision has increased in recent years, however, it is not known whether PrEP implementation has been equitably implemented across all risk groups, particularly groups experiencing high levels of health inequity. A PrEP care continuum (PCC) has been proposed to evaluate the success of PrEP implementation programmes, but the extent to which health equity characteristics are currently taken into account in the PCC has not been described. The objectives of this proposed systematic review are to (i) identify and collate outcome measure definitions for the main stages of the PCC (awareness, acceptability, uptake, adherence and retention), (ii) describe how equity characteristics are considered in outcome definitions of the PCC and (iii) describe data sources for capturing equity characteristics.Methods and analysisQuantitative studies published between 1 January 2012 and 3 March 2020 will be included. Five databases (MEDLINE, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts) will be searched to identify English language publications that include an outcome measure definition of at least one of the five main stages of the PCC. Risk of bias will be assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Data on outcome measure definitions and equity characteristics will be extracted. Results will be presented in a narrative synthesis and all findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete. The review findings will have relevance to healthcare professionals, policymakers and commissioners in informing how to best evaluate PrEP implementation programmes and inform new implementation strategies for vulnerable and less advantaged populations.PROSPERO registration numberCRD42020169779.

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Experiences of children who have been separated from a parent due to military deployment:a systematic review of reviews

BJPsych Open ◽

10.1192/bjo.2021.702 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S263-S263

Author(s):

Jennifer Kent ◽

Pamela Taylor ◽

Sarah Argent ◽

Narasha Kalebic

Keyword(s):

Systematic Review ◽

English Language ◽

Child Outcomes ◽

Physical Symptoms ◽

Mental Illnesses ◽

Military Deployment ◽

Parental Relationships ◽

Negative Effect ◽

Review Of Reviews ◽

Meta Analyses

AimsTo conduct a systematic review of reviews to investigate how military deployment of a parent affects his/her child, and the extent to which the child's own perspectives have been documented.BackgroundLengthy but finite disruptions to parenting in any form may affect child development and mental and physical health.Military deployment means weeks or months of separation from one parent.2016 figures for the U.S. military showed that 40.5% of military personnel have children, and of these 1.7 million children the largest percentage are aged between 0–5 years (37.8%).MethodSeven databases were searched: AMED, Web of Science, Scopus, EMBASE 1947, Joanna Briggs Institute EMP database, Ovid MEDLINE 1946 and PsycINFO 1806 from the inception of each electronic database until 31st March 2018.Inclusion criteria:Child and young adults aged 0–24 yearsEnglish language papers onlyAll papers being systematic reviews or meta-analysesA focus on documenting the effects on child outcomesData extracted included the review methods and child outcomes reported, including educational attainment; physical symptoms; mental illnesses or disorders; changes to behaviours, and effects on peer and parental relationships.ResultThe eight reviews identified included 32 common and relevant studies.Across the various studies, only about 20% of data came directly from children.Five papers extracted from the reviews identified parental deployment as having a negative effect on school attainment.Nine studies extracted from the review papers found a positive correlation between having a deployed parent and a greater chance of experiencing depressive symptoms and feelings of anxiety.Strong correlations of increased prevalence of both externalising & internalising behaviours were conclusively found in 7 of the reviews.Increased resilience was detailed in only one study featured in multiple reviews.Just one study featured across the reviews reported on physiological measures - adolescents with deployed parents had higher blood pressures and significantly higher heart rates and stress scores than civilian children.ConclusionMore research obtaining the viewpoint of the child directly and observation of such children is required to properly understand the effects on children with a deployed parent, without the interference of parent or teacher reporting bias. Additionally, with only one study reporting on increased offspring resilience there has been limited exploration of potential positive correlates, so further research regarding these is important.

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Etiology of community-acquired pneumonia in adults: a systematic review

Pneumonia ◽

10.1186/s41479-020-00074-3 ◽

2020 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Saeed Shoar ◽

Daniel M. Musher

Keyword(s):

Systematic Review ◽

Antibiotic Stewardship ◽

English Language ◽

Community Acquired Pneumonia ◽

Common Cause ◽

Empiric Antibiotic ◽

Empiric Antibiotic Treatment ◽

Bacterial Coinfection ◽

The One ◽

Meta Analyses

Abstract Background The etiology of community-acquired pneumonia (CAP) has evolved since the beginning of the antibiotic era. Recent guidelines encourage immediate empiric antibiotic treatment once a diagnosis of CAP is made. Concerns about treatment recommendations, on the one hand, and antibiotic stewardship, on the other, motivated this review of the medical literature on the etiology of CAP. Methods We conducted a systematic review of English-language literature on the etiology of CAP using methods defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed using a combination of the keywords ‘pneumonia’, ‘CAP’, ‘etiology’, ‘microbiology’, ‘bacteriology’, and ‘pathogen’. We examined articles on antibiotics that were develop to treat pneumonia. We reviewed all ‘related articles’ as well as studies referenced by those that came up in the search. After we excluded articles that did not give sufficient microbiological data or failed to meet other predetermined criteria, 146 studies remained. Data were stratified into diagnostic categories according to the microbiologic studies that were done; results are presented as the percentage in each category of all cases in which an etiology was established. Results Streptococcus pneumoniae remains the most common cause of CAP although declining in incidence; this decline has been greater in the US than elsewhere. Haemophilus influenzae is the second most common cause of CAP, followed by Staphylococcus aureus and Gram negative bacilli. The incidence of all bacteria as causes of CAP has declined because, with routine use of PCR for viruses, the denominator, cases with an established etiology, has increased. Viruses were reported on average in about 10% of cases, but recent PCR-based studies identified a respiratory virus in about 30% of cases of CAP, with substantial rates of viral/bacterial coinfection. Conclusion The results of this study justify current guidelines for initial empiric treatment of CAP. With pneumococcus and Haemophilus continuing to predominate, efforts at antibiotic stewardship might be enhanced by greater attention to the routine use of sputum Gram stain and culture. Because viral/bacterial coinfection is relatively common, the identification of a virus by PCR does not, by itself, allow for discontinuation of the antibiotic therapy.

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Proposal of a Functional Impairment Symptom Scale for Concussion

Journal of Child Neurology ◽

10.1177/0883073820945521 ◽

2020 ◽

Vol 35 (14) ◽

pp. 983-988

Author(s):

Matthew T. McCarthy ◽

Sarah Janse ◽

Natalie M. Pizzimenti ◽

Anthony K. Savino ◽

Brian Crosser ◽

...

Keyword(s):

Functional Impairment ◽

Assessment Tool ◽

Pearson Correlation ◽

Hazard Ratio ◽

Symptom Scale ◽

Prospective Longitudinal Study ◽

Point Increase ◽

Patient Reported ◽

Sport Concussion ◽

Prospective Longitudinal

Clinicians currently administer patient-reported symptom scales to quantify and track concussion symptoms. These scales are based on subjective ratings without reference to the degree of functional impairment caused by the symptoms. Our objective was to develop a concussion symptom scale based on functional impairment and compare it to a widely used concussion symptom checklist. We conducted a retrospective chart review evaluating 133 patients age 9-22 with an acute concussion who completed 2 symptom checklists at their initial visit—the Sport Concussion Assessment Tool (SCAT-3) symptom evaluation (22 symptoms, 0-6 scale) and the proposed Functional Impairment Scale (22 symptoms, 0-3 scale related to degree of functional impairment). Mean total symptom score was 27.2±22.9 for Sport Concussion Assessment Tool–3 and 14.7±11.9 for the Functional Impairment Scale. Pearson correlation between the scales was 0.98 ( P < .001). Mean time from concussion to first visit was 6.9±6.2 days, and median clearance time after injury was 19 (95% CI 16-21) days. After adjusting for patient and injury characteristics, an increased score on each scale was associated with longer time to clearance (5-point increase in Sport Concussion Assessment Tool–3 hazard ratio 0.885, 95% CI 0.835-0.938, P < .001; 2.5-point increase in Functional Impairment Scale hazard ratio 0.851, 95% CI 0.802-0.902, P < .001). We propose a concussion symptom scale based on functional impairment that correlates strongly with the Sport Concussion Assessment Tool–3 scale, demonstrates a similar association with time to clearance, and may provide a more intuitive approach to monitoring how symptoms are affecting patients recovering from concussion. Future research should aim to validate this scale through a prospective longitudinal study.

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The Berlin International Consensus Meeting on Concussion in Sport

Neurosurgery ◽

10.1093/neuros/nyx344 ◽

2017 ◽

Vol 82 (2) ◽

pp. 232-236 ◽

Cited By ~ 7

Author(s):

Gavin A Davis ◽

Richard G Ellenbogen ◽

Julian Bailes ◽

Robert C Cantu ◽

Karen M Johnston ◽

...

Keyword(s):

Systematic Review ◽

Consensus Statement ◽

Assessment Tool ◽

Expert Panel ◽

Consensus Meeting ◽

International Consensus ◽

International Conference ◽

Sport Concussion

Abstract The Fifth International Conference on Concussion in Sport was held in Berlin in October 2016. A series of 12 questions and subquestions was developed and the expert panel members were required to perform a systematic review to answer each question. Following presentation at the Berlin meeting of the systematic review, poster abstracts and audience discussion, the summary Consensus Statement was produced. Further, a series of tools for the management of sport-related concussion was developed, including the Sport Concussion Assessment Tool Fifth edition (SCAT5), the Child SCAT5, and the Concussion Recognition Tool Fifth edition. This paper elaborates on this process, the outcomes, and explores the implications for neurosurgeons in the management of sport-related concussion.

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The Efficacy of Recasts in Language Intervention: A Systematic Review and Meta-Analysis

American Journal of Speech-Language Pathology ◽

10.1044/2015_ajslp-14-0105 ◽

2015 ◽

Vol 24 (2) ◽

pp. 237-255 ◽

Cited By ~ 53

Author(s):

Patricia L. Cleave ◽

Stephanie D. Becker ◽

Maura K. Curran ◽

Amanda J. Owen Van Horne ◽

Marc E. Fey

Keyword(s):

Systematic Review ◽

Research Evidence ◽

Meta Analysis ◽

Language Intervention ◽

Effect Sizes ◽

Study Quality ◽

Average Effect ◽

Grammatical Development ◽

Meta Analyses ◽

Study Designs

Purpose This systematic review and meta-analysis critically evaluated the research evidence on the effectiveness of conversational recasts in grammatical development for children with language impairments. Method Two different but complementary reviews were conducted and then integrated. Systematic searches of the literature resulted in 35 articles for the systematic review. Studies that employed a wide variety of study designs were involved, but all examined interventions where recasts were the key component. The meta-analysis only included studies that allowed the calculation of effect sizes, but it did include package interventions in which recasts were a major part. Fourteen studies were included, 7 of which were also in the systematic review. Studies were grouped according to research phase and were rated for quality. Results Study quality and thus strength of evidence varied substantially. Nevertheless, across all phases, the vast majority of studies provided support for the use of recasts. Meta-analyses found average effect sizes of .96 for proximal measures and .76 for distal measures, reflecting a positive benefit of about 0.75 to 1.00 standard deviation. Conclusion The available evidence is limited, but it is supportive of the use of recasts in grammatical intervention. Critical features of recasts in grammatical interventions are discussed.

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New-Onset and Relapsed Kidney Histopathology Following COVID-19 Vaccination: A Systematic Review

Vaccines ◽

10.3390/vaccines9111252 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1252

Author(s):

Henry H. L. Wu ◽

Philip A. Kalra ◽

Rajkumar Chinnadurai

Keyword(s):

Systematic Review ◽

English Language ◽

Published Data ◽

Scleroderma Renal Crisis ◽

Qualitative Synthesis ◽

Vaccination Programs ◽

Relapsed Disease ◽

Meta Analyses ◽

New Onset

Introduction: The introduction of COVID-19 vaccination programs has become an integral part of the major strategy to reduce COVID-19 numbers worldwide. New-onset and relapsed kidney histopathology have been reported following COVID-19 vaccination, sparking debate on whether there are causal associations. How these vaccines achieve an immune response to COVID-19 and the mechanism that this triggers kidney pathology remains unestablished. We describe the results of a systematic review for new-onset and relapsed kidney histopathology following COVID-19 vaccination. Methods: A systematic literature search of published data up until 31 August 2021 was completed through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline. Research articles reporting new onset or relapsed kidney histopathology in adult patients (>18 years) following COVID-19 vaccination were included for qualitative review. Only full-text articles published in the English language were selected for review. Results: Forty-eight cases from thirty-six articles were included in the qualitative synthesis of this systematic review. Minimal change disease (19 cases) was the most frequent pathology observed, followed by IgA nephropathy (14 cases) and vasculitis (10 cases). Other cases include relapse of membranous nephropathy, acute rejection of kidney transplant, relapse of IgG4 nephritis, new-onset renal thrombotic microangiopathy, and scleroderma renal crisis following COVID-19 vaccination. There was no mortality reported in any of the included cases. Patients in all but one case largely recovered and did not require long-term renal replacement therapy. Conclusion: This systematic review provides insight into the relationship between various kidney pathologies that may have followed COVID-19 vaccination. Despite these reported cases, the protective benefits offered by COVID-19 vaccination far outweigh its risks. It would be recommended to consider early biopsy to identify histopathology amongst patients presenting with symptoms relating to new-onset kidney disease following vaccination and to monitor symptoms for those with potential relapsed disease.

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A Systematic Review of Social Media Integration to Teach Speaking

Sustainability ◽

10.3390/su13169047 ◽

2021 ◽

Vol 13 (16) ◽

pp. 9047

Author(s):

Emily John ◽

Melor Md Yunus

Keyword(s):

Systematic Review ◽

Social Media ◽

Teaching And Learning ◽

English Language ◽

Selection Process ◽

Systematic Analysis ◽

Social Media Platforms ◽

Use Of Social Media ◽

Meta Analyses ◽

Speaking Skills

The ubiquitous nature of social media (SM) makes it a very essential tool to use in the world of education, especially with the advent of the COVID-19 pandemic which has led to a paradigm shift in the approaches used in the teaching and learning of English language skills. This review focuses on the use of social media as a medium of instruction to aid the acquisition of speaking skills, which many learners find extremely challenging and inhibiting. Thus, this systematic review investigates the integration of social media in the teaching and learning of speaking skills. To ensure the systematic analysis of the selected articles, Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA) 2020 guidelines were utilized. A total of 36 peer-reviewed journal articles from the year 2016 to 2021 were accessed from two databases: ERIC and Google Scholar. Prior to the start of the review, an inclusion and exclusion criteria selection process was conducted to ensure the focus of the review. Overall, the articles reviewed presented the claim that the integration of social media is seen as a positive inclusion for the teaching of speaking skills using various social media applications. Findings reveal that there are improvements in speaking skills, as well as confidence to speak and a decline in speaking anxiety. Teachers and educators can now make use of the various social media platforms such as Telegram, Facebook, WhatsApp, and others to provide learners with more practice that is not only restricted to the classroom but has moved beyond it.

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Effect of periodontal therapy on the systemic inflammation and metabolic markers in patients undergoing hemodialysis or/and peritoneal dialysis: a systematic review and meta-analysis

10.21203/rs.2.15306/v1 ◽

2019 ◽

Author(s):

Hui Yue ◽

Xinxin Xu ◽

Qin Liu ◽

Xiaozhi Li ◽

Yiting Xiao ◽

...

Keyword(s):

Systematic Review ◽

Peritoneal Dialysis ◽

Assessment Tool ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Periodontal Treatment ◽

Sufficient Evidence ◽

Metabolic Markers ◽

Significant Difference ◽

Meta Analyses

Abstract Background: This systematic review aimed to investigate whether periodontal treatment can reduce the systemic inflammatory levels and improve the metabolic levels in patients undergoing hemodialysis (HD) or/and peritoneal dialysis (PD). Methods: Electronic databases (PubMed, EMBASE, CENTRAL, NCKI, and WFPD) were searched up to July 2019. The risk of bias within studies was assessed through the Cochrane Collaboration' s risk assessment tool. The systemic inflammatory and metabolic measures were the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumor necrosis factor-α (TNF-a), the albumin (Alb), and lipid metabolic levels. Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate. Results: Five studies were eligible for this systematic review. The result of four studies revealed a significant difference in the CRP level after periodontal treatment in patients receiving HD or/and PD. Two studies reported the IL-6 and the Alb level after periodontal treatment but revealed no significant difference. No MAs could be performed on the TNF- a level and the lipid metabolic markers. Conclusions: Periodontal treatment may moderately reduce the serum of CRP levels in HD or/and PD patients. For the TNF-a, IL-6, Alb levels and lipid metabolic markers, no sufficient evidence supports the difference after periodontal treatment. Therefore, larger scales and high-quality randomized-controlled trials (RCTs) are required to assess the effect of periodontal treatment on systemic inflammatory and metabolic parameters in HD or/and PD patients.

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Sport Concussion Assessment Tool-5th Edition (SCAT5): Normative Reference Values for the National Rugby League Women's Premiership

Frontiers in Sports and Active Living ◽

10.3389/fspor.2021.653743 ◽

2021 ◽

Vol 3 ◽

Author(s):

Grant L. Iverson ◽

David R. Howell ◽

Ryan Van Patten ◽

Paul Bloomfield ◽

Andrew J. Gardner

Keyword(s):

Reference Values ◽

Scoring System ◽

Normative Data ◽

Assessment Tool ◽

Case Series ◽

Rugby League ◽

Standardized Assessment ◽

Clinical Interpretation ◽

Sport Concussion ◽

Balance Error

Objective: To establish normative reference values for the Sport Concussion Assessment Tool-5th Edition (SCAT5) for the new National Rugby League Women's Premiership.Methods: Preseason SCAT5 baseline testing was administered individually to all National Rugby League Women's Premiership players (N = 117). Testing was completed by the medical staff. Normative reference values were calculated for the components of the SCAT5, including the Standardized Assessment of Concussion, modified Balance Error Scoring System, and the Symptom Scale. A small case series of players who sustained concussions were included to illustrate the use of the new normative data.Results: The median Standardized Assessment of Concussion total score was 27.0 (M = 26.9, SD = 2.1). The median modified Balance Error Scoring System score was 2.0 (M = 2.4, SD = 2.2). The median number of symptoms score was 1.0 (M = 3.2, SD = 4.7) and the median symptom severity score was 2.0 (M = 5.4, SD = 8.2). The most common baseline symptom was fatigue or low energy (33%), followed by trouble sleeping (24%), headache (23%), neck pain (22%), and difficulty remembering (21%). In the total sample, 41% reported no symptoms. The clinical interpretation of these new normative data to a case series of women with concussions is provided.Conclusions: Normative reference values are provided for the SCAT5 for women who are professional rugby league players. Using these normative data will improve clinical interpretation of SCAT5 scores following a concussion.

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