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  1. Angela Gisselman1,
  2. Ronan Kearney2,
  3. Christina Le3,
  4. Brady Desmond Green4
  1. 1University of Otago, Dunedin, New Zealand
  2. 2Royal College of Surgeons in Ireland, Dublin, Ireland
  3. 3Glen Sather Sports Medicine Clinic, Edmonton, Alberta, Canada
  4. 4Department of Physiotherapy, La Trobe University, Bundoora, Victoria, Australia
  1. Correspondence to Dr Ronan Kearney; ronankearney{at}rcsi.ie

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Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football

JAMA 2017; 318:360-370

You may have already seen the results of this paper through a media outlet. Let’s take a closer look. This study represents the largest case series of deceased American football players who donated their brains for research. At first glance the results appear shocking but further consideration is needed.

Chronic traumatic encephalopathy (CTE) was diagnosed in 177 of 202 (87%) deceased players, including a subgroup of NFL players in which CTE was identified in 99% of cases. Suicide was the most common cause of death in mild CTE, and dementia or parkinsonian-related disease in severe CTE.

The majority of players in this study were at the elite level, so caution must be taken when generalising results to other football players. The authors also acknowledged that the cohort was a ‘conveniently’ selected sample and had an ascertainment bias due to athletes’ participation in the brain donation programme. Furthermore, …

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