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To document false-positive scores on the sport concussion assessment tool (scat3) in high school athletes
  1. Tracey Covassin1,
  2. RJ Elbin2,
  3. Philip Schatz3,
  4. Erica Beidler4,
  5. Jessica Wallace5
  1. 1Michigan State University, East Lansing MI
  2. 2University of Arkansas, Fayetteville, AR
  3. 3Saint Josephs University, Philadelphia PA
  4. 4Duquesne University, Pittsburgh, Pennsylvania
  5. 5Youngstown State University, Youngstown, OH

Abstract

Objective To document false-positive scores on the Sport Concussion Assessment Tool(SCAT3) in high school athletes.

Design Pre-Test Only.

Setting Six high schools in the Mid-West and Central Region of the USA.

Participants The sample was composed of a total of 489 high school athletes who completedall components of the SCAT3: 157 female (Mean age=15.6, SD=1.8 years) and 322 male(Mean age=15.9, SD=1.5 years) adolescent athletes.

Intervention The SCAT3 was administered to all athletes.

Outcome measures Cases were identified as “false-positive” by surpassing cutoff scores using 95% confidence intervals from the sample on SCAT3 components: Standardised Assessment ofConcussion (SAC: Mean 26.06±2.34, Cutoff<21), total severity of symptoms (Males: Mean:3.24±5.93, Cutoff>15; Females: Mean: 4.16±6.96, cutoff>18), tandem gait (Mean:15.55±4.52, Cutoff>25 sec), and total errors on the modified Balance Error Scoring System(mBESS: Mean: 3.42±2.67, Cutoff>9 errors).

Main results Overall, 16% of athletes (n=78) obtained scores falling beyond false-positivecutoffs on at least one sub-component of the SCAT, and only 2% (N=10) obtained two or morescores beyond cutoffs. False-positive rates on individual components were as follows: SAC:5.7% (n=28), mBESS: 5.5% (n=27), tandem gait: 3.9% (n=19), total symptom severity: 4.9% (n=24).

Conclusions While rates of false positives fell generally within 95% CIs for individual components of the SCAT, the overall SCAT3 false-positive rate was 16%. Comparisons between post-concussion and baseline SCAT3 data should be based on 2 or more components falling outside 95% CIs.

Competing interests Dr. Schatz serves on the ImPACT Scientific Advisory Board

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