Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics & Numerical Data], Physical Therapy Specialty/sn [Statistics & Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {*Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics \& Numerical Data], Physical Therapy Specialty/sn [Statistics \& Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Leiter, J; Hall, T; McDonald, P J; Sawyer, S; Silver, N; Bunge, M; Essig, M
Neuroimaging findings in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 3, pp. 241–247, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed
@article{Ellis2015b,
title = {Neuroimaging findings in pediatric sports-related concussion},
author = {Ellis, M J and Leiter, J and Hall, T and McDonald, P J and Sawyer, S and Silver, N and Bunge, M and Essig, M},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {3},
pages = {241--247},
abstract = {OBJECT: The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. METHODS: The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age \< 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. RESULTS: A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). CONCLUSIONS: Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide information that impacts decision making about return to play and retirement from the sport.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Leiter, J; Hall, T; McDonald, P J; Sawyer, S; Silver, N; Bunge, M; Essig, M
Neuroimaging findings in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 3, pp. 241–247, 2015.
@article{Ellis2015b,
title = {Neuroimaging findings in pediatric sports-related concussion},
author = {Ellis, M J and Leiter, J and Hall, T and McDonald, P J and Sawyer, S and Silver, N and Bunge, M and Essig, M},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {3},
pages = {241--247},
abstract = {OBJECT: The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. METHODS: The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age \< 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. RESULTS: A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). CONCLUSIONS: Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide information that impacts decision making about return to play and retirement from the sport.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Lombardi, N J; Tucker, B; Freedman, K B; Austin, L S; Eck, B; Pepe, M; Tjoumakaris, F P
Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine Journal Article
In: Orthopedics, vol. 39, no. 5, pp. e944–9, 2016.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics & Numerical Data], Physical Therapy Specialty/sn [Statistics & Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]
@article{Lombardi2016,
title = {Accuracy of Athletic Trainer and Physician Diagnoses in Sports Medicine},
author = {Lombardi, N J and Tucker, B and Freedman, K B and Austin, L S and Eck, B and Pepe, M and Tjoumakaris, F P},
year = {2016},
date = {2016-01-01},
journal = {Orthopedics},
volume = {39},
number = {5},
pages = {e944--9},
abstract = {It is standard practice in high school athletic programs for certified athletic trainers to evaluate and treat injured student athletes. In some cases, a trainer refers an athlete to a physician for definitive medical management. This study was conducted to determine the rate of agreement between athletic trainers and physicians regarding assessment of injuries in student athletes. All high school athletes who were injured between 2010 and 2012 at 5 regional high schools were included in a research database. All patients who were referred for physician evaluation and treatment were identified and included in this analysis. A total of 286 incidents met the inclusion criteria. A total of 263 (92%) of the athletic trainer assessments and physician diagnoses were in agreement. In the 23 cases of disagreement, fractures and sprains were the most common injuries. Kappa analysis showed the highest interrater agreement in injuries classified as dislocations and concussions and the lowest interrater agreement in meniscal/labral injuries and fractures. In the absence of a confirmed diagnosis, agreement among health care providers can be used to infer accuracy. According to this principle, as agreement between athletic trainers and physicians improves, there is a greater likelihood of arriving at the correct assessment and treatment plan. Athletic trainers are highly skilled professionals who are well trained in the evaluation of athletic injuries. The current study showed that additional training in identifying fractures may be beneficial to athletic trainers and the athletes they treat. [Orthopedics. 2016; 39(5):e944-e949.]. Copyright 2016, SLACK Incorporated.},
keywords = {*Athletic Injuries/di [Diagnosis], *Consensus, *Orthopedics/st [Standards], *Physical Therapy Specialty/st [Standards], *Referral and Consultation, Adolescent, Athletes, Athletic Injuries/ep [Epidemiology], Bone/di [Diagnosis], Bone/ep [Epidemiology], Brain Concussion/di [Diagnosis], Brain Concussion/ep [Epidemiology], Contusions/di [Diagnosis], Contusions/ep [Epidemiology], Female, Fractures, Humans, Male, Observer Variation, Orthopedics/sn [Statistics \& Numerical Data], Physical Therapy Specialty/sn [Statistics \& Numeri, Schools, Sports, SPORTS medicine, Sprains and Strains/di [Diagnosis], Sprains and Strains/ep [Epidemiology]},
pubstate = {published},
tppubtype = {article}
}
Ellis, M J; Leiter, J; Hall, T; McDonald, P J; Sawyer, S; Silver, N; Bunge, M; Essig, M
Neuroimaging findings in pediatric sports-related concussion Journal Article
In: Journal of Neurosurgery. Pediatrics., vol. 16, no. 3, pp. 241–247, 2015.
Abstract | BibTeX | Tags: *Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed
@article{Ellis2015b,
title = {Neuroimaging findings in pediatric sports-related concussion},
author = {Ellis, M J and Leiter, J and Hall, T and McDonald, P J and Sawyer, S and Silver, N and Bunge, M and Essig, M},
year = {2015},
date = {2015-01-01},
journal = {Journal of Neurosurgery. Pediatrics.},
volume = {16},
number = {3},
pages = {241--247},
abstract = {OBJECT: The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. METHODS: The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age \< 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. RESULTS: A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). CONCLUSIONS: Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide information that impacts decision making about return to play and retirement from the sport.},
keywords = {*Athletic Injuries/di [Diagnosis], *Brain Concussion/di [Diagnosis], *Brain Concussion/et [Etiology], *Neuroimaging, Adolescent, Arachnoid Cysts/di [Diagnosis], Athletic Injuries/co [Complications], Athletic Injuries/pa [Pathology], Brain Concussion/pa [Pathology], Brain Injuries/di [Diagnosis], Brain Injuries/et [Etiology], Child, Contusions/di [Diagnosis], Dizziness/et [Etiology], Female, Follow-Up Studies, Headache/et [Etiology], Humans, Intracranial Hemorrhages/di [Diagnosis], Magnetic Resonance Imaging, Male, Neuroimaging/mt [Methods], postural balance, Predictive Value of Tests, Retrospective Studies, Skull Fractures/di [Diagnosis], Tomography, Unconsciousness/et [Etiology], X-Ray Computed},
pubstate = {published},
tppubtype = {article}
}