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What counts as ‘the evidence’? A need for an urgent review of injury risk in school rugby
  1. Joe Piggin,
  2. Alan Bairner
  1. School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
  1. Correspondence to Dr Joe Piggin, School of Sport, Exercise and Health Sciences, Loughborough University, LE113TU, UK; j.j.piggin{at}

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In March 2016, an open letter called for the removal of tackling in school rugby union.1 In response, the Chief Medical Officers (CMOs) of the UK consulted, gathered evidence and continued with the status quo—they endorsed tackling in school rugby.2 The CMOs stated that ‘the evidence does not support the conclusions and recommendations laid out in [the] open letter’. The CMOs relied on a report from the UK Physical Activity Expert Group (PAEG) and a review article by Dr Ross Tucker and colleagues in the British Journal of Sports Medicine.3 4

We highlight five problems with the evidence that the CMOs used to make their decision stemming from a report to the CMOs by the PAEG.

Prevalence of concussion

In responding to an assertion that ‘concussion is a common injury’ in rugby, the PAEG stated: ‘It seems that before the sustained programme of education and awareness in rugby concussions were under reported, and it may be now that true concussion is over-reported, making it currently difficult to ascertain where the true incidence lies’. We draw the PAEG’s attention to research published in 2016 about attitudes towards concussion in community rugby.5 Based on qualitative research with 20 young male …

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  • Contributors JP conceived and conducted the initial analysis. AB provided critical evaluation, and crafting and shaping of the final rendition.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.