Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},
pubstate = {published},
tppubtype = {article}
}
Hinton-Bayre, A D
Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion Journal Article
In: Brain Impairment, vol. 16, no. 2, pp. 80–89, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury
@article{Hinton-Bayre2015,
title = {Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion},
author = {Hinton-Bayre, A D},
doi = {10.1017/BrImp.2015.14},
year = {2015},
date = {2015-01-01},
journal = {Brain Impairment},
volume = {16},
number = {2},
pages = {80--89},
abstract = {Objective: Obtaining baseline neuropsychological (NP) data to assist management of sports-related concussion has been considered the standard of care. The validity of this approach has been questioned, with suggestions that post-concussion testing alone will suffice. The present study compared the sensitivity of baseline and normative paradigms in the setting of sports-related concussion. Method: Baseline NP data were collected for 194 Australian rugby league athletes on a brief battery of paper-and-pencil NP tests. During competition, 27 athletes sustaining concussion referred from a sports physician were retested within two days of injury. Twenty-six uninjured controls were assessed at similar intervals. The baseline paradigm was assessed using a reliable change index for pre- and post-concussion scores. The normative paradigm was assessed comparing the post-concussion score to a normative mean. Results: The baseline paradigm was consistently more sensitive to negative change following concussion than the normative paradigm when using continuous data, despite reasonable agreement. However, when data were categorised as 'impaired' or 'not-impaired', using either 68% or 90% confidence intervals, the difference between paradigms failed to reach significance. Comparison of ROC curves for both paradigms found superior overall classification for one test and the composite score using baseline comparison data. Conclusions: Despite being a time and resource intensive process, the baseline paradigm as a repeated-measures design may be more sensitive than the between-subjects design of the normative paradigm for detecting changes following concussion. Further work is required to determine the validity of normative assessment in sports-related concussion. Copyright © Australasian Society for the Study of Brain Impairment 2015.},
keywords = {adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Hinton-Bayre, A D
Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion Journal Article
In: Brain Impairment, vol. 16, no. 2, pp. 80–89, 2015.
@article{Hinton-Bayre2015,
title = {Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion},
author = {Hinton-Bayre, A D},
doi = {10.1017/BrImp.2015.14},
year = {2015},
date = {2015-01-01},
journal = {Brain Impairment},
volume = {16},
number = {2},
pages = {80--89},
abstract = {Objective: Obtaining baseline neuropsychological (NP) data to assist management of sports-related concussion has been considered the standard of care. The validity of this approach has been questioned, with suggestions that post-concussion testing alone will suffice. The present study compared the sensitivity of baseline and normative paradigms in the setting of sports-related concussion. Method: Baseline NP data were collected for 194 Australian rugby league athletes on a brief battery of paper-and-pencil NP tests. During competition, 27 athletes sustaining concussion referred from a sports physician were retested within two days of injury. Twenty-six uninjured controls were assessed at similar intervals. The baseline paradigm was assessed using a reliable change index for pre- and post-concussion scores. The normative paradigm was assessed comparing the post-concussion score to a normative mean. Results: The baseline paradigm was consistently more sensitive to negative change following concussion than the normative paradigm when using continuous data, despite reasonable agreement. However, when data were categorised as 'impaired' or 'not-impaired', using either 68% or 90% confidence intervals, the difference between paradigms failed to reach significance. Comparison of ROC curves for both paradigms found superior overall classification for one test and the composite score using baseline comparison data. Conclusions: Despite being a time and resource intensive process, the baseline paradigm as a repeated-measures design may be more sensitive than the between-subjects design of the normative paradigm for detecting changes following concussion. Further work is required to determine the validity of normative assessment in sports-related concussion. Copyright © Australasian Society for the Study of Brain Impairment 2015.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Schulte, S; Rasmussen, N N; McBeth, J W; Richards, P Q; Yochem, E; Petron, D J; Strathmann, F G
In: EPMA Journal, vol. 7, no. 1, 2016.
Abstract | Links | BibTeX | Tags: adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study
@article{Schulte2016b,
title = {Utilization of the clinical laboratory for the implementation of concussion biomarkers in collegiate football and the necessity of personalized and predictive athlete specific reference intervals},
author = {Schulte, S and Rasmussen, N N and McBeth, J W and Richards, P Q and Yochem, E and Petron, D J and Strathmann, F G},
doi = {10.1186/s13167-016-0050-x},
year = {2016},
date = {2016-01-01},
journal = {EPMA Journal},
volume = {7},
number = {1},
abstract = {Background: A continued interest in concussion biomarkers makes the eventual implementation of identified biomarkers into routine concussion assessment an eventual reality. We sought to develop and test an interdisciplinary approach that could be used to integrate blood-based biomarkers into the established concussion management program for a collegiate football team. Methods: We used a CLIA-certified laboratory for all testing and chose biomarkers where clinically validated testing was available as would be required for results used in clinical decision making. We summarized the existing methods and results for concussion assessment across an entire season to identify and demonstrate the challenges with the eventual integration of a parallel process using blood-based tests for concussion management. We analyzed the results of the biomarkers chosen for trends consistent with the outcome assessments provided from the current concussion management protocols. Results: Baseline samples were collected with three additional post-concussion samples collected at three separate time points from players with a diagnosed concussion (n = 12). A summary of results from currently used concussion assessment tools were compared to the representative biomarkers S100B and NSE results. Nine sport-related concussions occurred during practice and three during play. For S100B, 50% had follow-up testing results lower than the post-injury result. In contrast, 92% of NSE follow-up results were lower than post-injury. One hundred percent of the results for S100B and NSE were within the athlete-derived reference intervals upon return-to-play and season end. Conclusions: The reported workflow provides a framework for the eventual implementation of biomarkers for concussion assessment into existing assessment protocols and strengthens the need for reliance on clinical laboratory testing. Athlete-specific reference intervals will be required to adequately interpret results. © 2016 Schulte et al.},
keywords = {adult, Article, athlete-derived reference interval, biological marker, Biomarker panel, Blood test, clinical decision making, clinical laboratory, college, collegiate athletes, Concussion, controlled study, diagnostic test accuracy study, follow up, football, health program, human, Male, neuron specific enolase, NSE, prediction, Predictive diagnostics, priority journal, protein blood level, protein S100B, rating scale, reference value, S100B, Sport-related concussion, Sports-related concussion, traumatic brain injury, validation study},
pubstate = {published},
tppubtype = {article}
}
Hinton-Bayre, A D
Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion Journal Article
In: Brain Impairment, vol. 16, no. 2, pp. 80–89, 2015.
Abstract | Links | BibTeX | Tags: adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury
@article{Hinton-Bayre2015,
title = {Normative Versus Baseline Paradigms for Detecting Neuropsychological Impairment Following Sports-Related Concussion},
author = {Hinton-Bayre, A D},
doi = {10.1017/BrImp.2015.14},
year = {2015},
date = {2015-01-01},
journal = {Brain Impairment},
volume = {16},
number = {2},
pages = {80--89},
abstract = {Objective: Obtaining baseline neuropsychological (NP) data to assist management of sports-related concussion has been considered the standard of care. The validity of this approach has been questioned, with suggestions that post-concussion testing alone will suffice. The present study compared the sensitivity of baseline and normative paradigms in the setting of sports-related concussion. Method: Baseline NP data were collected for 194 Australian rugby league athletes on a brief battery of paper-and-pencil NP tests. During competition, 27 athletes sustaining concussion referred from a sports physician were retested within two days of injury. Twenty-six uninjured controls were assessed at similar intervals. The baseline paradigm was assessed using a reliable change index for pre- and post-concussion scores. The normative paradigm was assessed comparing the post-concussion score to a normative mean. Results: The baseline paradigm was consistently more sensitive to negative change following concussion than the normative paradigm when using continuous data, despite reasonable agreement. However, when data were categorised as 'impaired' or 'not-impaired', using either 68% or 90% confidence intervals, the difference between paradigms failed to reach significance. Comparison of ROC curves for both paradigms found superior overall classification for one test and the composite score using baseline comparison data. Conclusions: Despite being a time and resource intensive process, the baseline paradigm as a repeated-measures design may be more sensitive than the between-subjects design of the normative paradigm for detecting changes following concussion. Further work is required to determine the validity of normative assessment in sports-related concussion. Copyright © Australasian Society for the Study of Brain Impairment 2015.},
keywords = {adult, Article, athlete, Australian, Concussion, controlled study, data processing, diagnostic test accuracy study, disease association, disease classification, human, major clinical study, Male, medical assessment, mild traumatic brain injury, neurocognitive, neuropsychological test, Patient Assessment, psychopathy, receiver operating characteristic, reference value, reliability, reliable change, rugby, scoring system, sensitivity analysis, Sensitivity and Specificity, sport injury},
pubstate = {published},
tppubtype = {article}
}