• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Neurology

Researchers validate scoring of postconcussive symptom measure to characterize duration 

byMatthew Lin, MDandLeah Carr, MD
January 30, 2017
in Neurology, Pediatrics
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. After analyzing multiple approaches to the Postconcussion Symptom Inventory (PCSI), researchers found that an increase in severity on 2 or more PCSI items by 1 point or more offered the highest sensitivity in identifying those at risk for prolonged symptomatology.

Evidence Rating: 1 (Excellent)

Study Rundown: Traumatic brain injury (TBI) is a significant pediatric problem, with concussions comprising approximately 90% of all TBIs. Despite a large body of research on the postconcussive pediatric course, there are no clear guidelines on how to best use existing assessment tools in stratifying risk for persistent postconcussive symptoms (PCS). The PCSI is one such tool, which has been validated in children as young as 5 years of age. In the current study, researchers evaluated existing and novel PCSI scoring cutoffs in identifying symptomatic patients at 2 weeks post-injury with clinical judgement as the comparative gold standard. In their assessment of existing cutoffs, they found that a modified version of Zemek et al’s (2013) binary classification system—an increase in severity in 2 or more individual PCSI items by 1 point or more from preinjury to time 2, was the most successful at identifying symptomatic patients. Limitations of this study include using subjective clinical judgement as the comparative baseline to PCSI scores, poor generalizability as the study was completed in the emergency room at a single institution, and recruitment of less than a third of all eligible participants. Overall, this study offers a suggested validated index of pediatric concussion recovery at 2 weeks that may inform physician’s ability to counsel patients on postconcussive course and appropriate timing for returning to daily activities.

Click to read the study, published today in Pediatrics

Relevant Reading: Predicting and preventing postconcussive problems in pediatrics (5P) study: Protocol for a prospective multicenter clinical prediction rule derivation study in children with concussion

In-Depth [prospective cohort]: In this single site, prospective, longitudinal study, a total of 1205 pediatric patients between 5-18 years of age were recruited within 48 hours of experiencing an mTBI. Postconcussive symptoms were assessed at time of presentation, at 1 to 4 days post-injury, and 2 weeks post-injury. The primary outcome was presence of PCS determined by applying existing and novel classification systems to parent-rated PCSIs. The PCSI is a 21-item questionnaire that includes cognitive, emotional, physical and sleep-based symptomology questions. The gold standard for comparison was physician clinical judgement. Interrater reliability of clinician assessment of symptomatic/asymptomatic had a ĸ = 0.90, indicating almost perfect agreement between clinicians regarding who was positive or negative for PCS. The authors analyzed the sensitivities of PCSI cutoffs for identifying PCS published by Zemek et al (2013), Barlow et al (2014), and Smyth et al (2015). The Zemek et al criteria had the highest true positive rate (47% identified as positive for PCS, sensitivity = 78.3%). The sensitivities for Smyth et al and Barlow et al were 73.9% and 69.6%, respectively. Area under the curve (AUC) values – or indices of accuracy in distinguishing between PCS and non-PCS patients – for Zemek et al, Smyth et al, and Barlow et al were 0.70, 0.69, and 0.72, respectively. All criteria were significantly better than chance at identifying PCS post-injury. The Barlow et al criteria had the highest diagnostic of OR = 7.0, while Zemek et al had an OR = 5.6, and Smyth et al had an OR = 5.3. The authors novel cutoffs consisted of expanding or decreasing the range of items to be rated for time change in severity. They found that altering the Zemek et al score system to include an increase in severity in 2 or more individual PCSI items by 1 point to increase to 95.6%.

©2017 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

RELATED REPORTS

Concussions associated with adverse mental health outcomes in children

Increased affective and sleep symptoms reported after late presentation for concussion

Traumatic brain injury associated with increased all-cause mortality risk for military veterans

Tags: Concussionmild traumatic brain injury (mTBI)sports medicine
Previous Post

External compression computed tomography may increase diagnostic accuracy in appendicitis

Next Post

Medical residents spend more time using computers than on patient interaction

RelatedReports

Removing athletes from play following concussions may shorten recovery time
Chronic Disease

Concussions associated with adverse mental health outcomes in children

March 7, 2022
Researchers validate scoring of postconcussive symptom measure to characterize duration 
Chronic Disease

Increased affective and sleep symptoms reported after late presentation for concussion

February 21, 2022
Diffusion tensor imaging valuable in the evaluation of peripheral neuropathy
Cardiology

Traumatic brain injury associated with increased all-cause mortality risk for military veterans

April 7, 2022
#VisualAbstract: Dual therapy with infliximab and IVIG in children with multi-system inflammatory syndrome
StudyGraphics

#VisualAbstract: Avoiding screen time after concussion may shorten recovery time

April 13, 2022
Next Post
American Academy of Pediatrics recommends standards for adverse event disclosures

Medical residents spend more time using computers than on patient interaction

AAP supports mindfulness of children’s media consumption

Young men exposed to violence at risk for carrying guns

Lessons from real-world implementation of lung cancer screening

Lessons from real-world implementation of lung cancer screening

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

Get 2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • #VisualAbstract: Severe actinic keratosis and need for additional treatment are markers for an increased risk of cutaneous squamous cell carcinoma
  • Virtual yoga and meditation intervention may be associated with increased health-related quality of life
  • Wellness Check: Mental Health
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.