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Amsterdam 2022 process: A summary of the methodology for the Amsterdam International Consensus on Concussion in Sport
  1. Kathryn J Schneider1,2,3,
  2. Jon S Patricios4,
  3. Willem Meeuwisse5,
  4. Geoff M Schneider6,
  5. K Alix Hayden7,
  6. Zahra Premji8,
  7. Osman Hassan Ahmed9,10,11,
  8. Cheri Blauwet12,13,
  9. Steven Broglio14,
  10. Robert C Cantu15,16,
  11. Gavin A Davis17,18,
  12. Jiri Dvorak19,
  13. Ruben J Echemendia20,
  14. Carolyn A Emery1,
  15. Grant L Iverson21,22,
  16. John J Leddy23,
  17. Michael Makdissi24,25,
  18. Michael McCrea26,
  19. Michael McNamee27,28,
  20. Margot Putukian29,
  21. Keith Owen Yeates2,3,30,
  22. Amanda M Black1,
  23. Joel S Burma1,
  24. Meghan Critchley31,
  25. Paul H Eliason31,
  26. Anu M Räisänen32,
  27. Jason B Tabor31,
  28. Clodagh Toomey1,33,
  29. Paul E Ronksley34,
  30. J David Cassidy35
  1. 1 Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  2. 2 Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
  3. 3 Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
  4. 4 Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  5. 5 National Hockey League, New York City, New York, USA
  6. 6 Department of Radiology, University of Calgary, Calgary, Alberta, Canada
  7. 7 Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
  8. 8 Libraries, University of Victoria, Victoria, British Columbia, Canada
  9. 9 Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Poole, UK
  10. 10 The FA Centre for Para Football Research, The Football Association, Burton-Upon-Trent, UK
  11. 11 School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
  12. 12 Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation, Spaulding Hospital/Brigham and Women’s Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
  13. 13 Kelley Adaptive Sports Research Institute, Boston, Massachusetts, USA
  14. 14 Michigan Concussion Center, University of Michigan, Ann Arbor, Michigan, USA
  15. 15 Centre for the Study of Traumatic Encephalopathy, Boston University School of Medicine, Boston, Massachusetts, USA
  16. 16 Neurosurgery, Boston University School of Medicine, Boston, Massachusetts, USA
  17. 17 Murdoch Children's Research Institute, Parkville, Victoria, Australia
  18. 18 Cabrini Health, Malvern, Victoria, Australia
  19. 19 Spine Unit, Schulthess Clinic Human Performance Lab, Zurich, Switzerland
  20. 20 Psychology, University of Missouri Kansas City, Kansas City, Missouri, USA
  21. 21 Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
  22. 22 Sports Concussion Program, MassGeneral Hospital for Children, Boston, Massachusetts, USA
  23. 23 UBMD Orthopaedics and Sports Medicine, SUNY Buffalo, Buffalo, New York, USA
  24. 24 Florey Institute of Neuroscience and Mental Health - Austin Campus, Heidelberg, Victoria, Australia
  25. 25 La Trobe Sport and Exercise Medicine Research Centre, Melbourne, Victoria, Australia
  26. 26 Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
  27. 27 Department of Movement Sciences, Katholieke Universiteit (KU) Leuven, Leuven, Belgium
  28. 28 Swansea University, Swansea, UK
  29. 29 Major League Soccer, Major League Soccer, New York, New York, USA
  30. 30 Department of Psychology, University of Calgary, Calgary, Alberta, Canada
  31. 31 University of Calgary, Calgary, Alberta, Canada
  32. 32 Department of Physical Therapy Education - Oregon, Western University of Health Sciences College of Health Sciences - Northwest, Lebanon, Oregon, USA
  33. 33 School of Allied Health, University of Limerick, Limerick, Ireland
  34. 34 Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
  35. 35 Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Kathryn J Schneider, University of Calgary, Calgary, Alberta, T2N 1N4, Canada; kjschnei{at}


The purpose of this paper is to summarise the consensus methodology that was used to inform the International Consensus Statement on Concussion in Sport (Amsterdam 2022). Building on a Delphi process to inform the questions and outcomes from the 5th International Conference on Concussion in Sport, the Scientific Committee identified key questions, the answers to which would help encapsulate the current science in sport-related concussion and help guide clinical practice. Over 3½ years, delayed by 2 years due to the pandemic, author groups conducted systematic reviews on each selected topic. The 6th International Conference on Concussion in Sport was held in Amsterdam (27–30 October 2022) and consisted of 2 days of systematic review presentations, panel discussions, question and answer engagement with the 600 attendees, and abstract presentations. This was followed by a closed third day of consensus deliberations by an expert panel of 29 with observers in attendance. The fourth day, also closed, was dedicated to a workshop to discuss and refine the sports concussion tools (Concussion Recognition Tool 6 (CRT6), Sport Concussion Assessment Tool 6 (SCAT6), Child SCAT6, Sport Concussion Office Assessment Tool 6 (SCOAT6) and Child SCOAT6). We include a summary of recommendations for methodological improvements for future research that grew out of the systematic reviews.

  • Consensus
  • Methodology
  • Sport
  • Brain Concussion

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  • Twitter @Kat_Schneider7, @jonpatricios, @osmanhahmed, @CheriBlauwetMD, @ProfJiriDvorak, @CarolynAEmery, @Mputukian, @aacademic, @amraisanen, @clo2me

  • Contributors KJS was responsible for the initial development of the methodology (in collaboration with JP, OHA, CB, GAD, JD, RJE, MM, WM) and drafting of the manuscript in collaboration with all other authors. KAH and ZP were involved in the development of and completion of the searches; GMS, JDC and KJS were responsible for development of the risk of bias tools and training, MMcN was responsible for the ethics aspects of the work. All authors critically reviewed and approved the manuscript.

  • Funding Educational grant from the Concussion in Sport International Consensus Conference Organizing Committee through Publi Creations for partial administrative and operational costs associated with the writing of the systematic reviews.

  • a Competing interests OHA is a Senior Physiotherapist at University Hospitals Dorset NHS Foundation Trust (England) and is Para Football Physiotherapy Lead/Para Football Classification Lead at the Football Association (England). He also works on a consultancy basis with the Football Association as the squad physiotherapist to the England Cerebral Palsy Football squad, and teaches on the Football Association’s Advanced Trauma and Medical Management in Football course on a consultancy basis. He has a Visiting Senior Lecturer position at the University of Portsmouth, England (unpaid). He sits on several disability sport committees including Para Football Foundation as Medical Unit Co-Lead (unpaid), the International Federation of Cerebral Palsy Football as Medical and Sports Science Director (unpaid), and the International Blind Sports Association as Medical Committee member (unpaid). He has Associate Editor positions at the British Journal of Sports Medicine (unpaid) and British Medical Journal (BMJ) Open Sports & Exercise Medicine (unpaid). He is also an Institutional Ethics Committee external member for World Rugby (unpaid), and co-chair of the Concussion in Para Sport Group (unpaid). AB has received peer-reviewed research funding from the Social Sciences and Humanities Research Council. She is also a Sport Information Resource Centre board member and Canadian Athletic Therapists Association committee member. She has received an honorarium for the administrative aspects of the reviews. CB is an Associate Professor of Physical Medicine & Rehabilitation (PM&R) at Spaulding Rehabilitation Hospital/Harvard Medical School and Chief Medical Officer at Spaulding Rehabilitation Hospital. She receives grant funding from the United States (US) Center for Disease Control (CDC) and Prevention and the U.S. National Institute on Disability, Independent Living, and Rehabilitation Research. She serves on the Board of Directors of the United States Olympic & Paralympic Committee (unpaid) as well as the International Paralympic Committee Medical Committee (unpaid) and the International Olympic Committee Medical & Scientific Commission (unpaid). She serves as an Associate Editor of the British Journal of Sports Medicine (unpaid) as well as the PM&R Journal (unpaid). SB current or past research funding from the National Institutes of Health; Centers for Disease Control and Prevention (CDC); Department of Defense - USA Medical Research Acquisition Activity, National Collegiate Athletic Association (NCAA); National Athletic Trainers’ Association Foundation; National Football League (NFL)/Under Armour/General Electric (GE); Simbex; and ElmindA. He has consulted for US Soccer (paid), US Cycling (unpaid), University of Calgary SHRed Concussions external advisory board (unpaid), medicolegal litigation, and received speaker honorarium and travel reimbursements (including Concussion in Sport Group -CISG) for talks given. He is coauthor of “Biomechanics of Injury (3rd edition)” and has a patent pending on “Brain Metabolism Monitoring Through CCO Measurements Using All-Fiber-Integrated Super-Continuum Source” (US Application No. 17/164,490). He is/was on the editorial boards (all unpaid) for Journal of Athletic Training (2015 to present), Concussion (2014 to present), Athletic Training & Sports Health Care (2008 to present), British Journal of Sport Medicine (2008 to 2019). JSB is supported by the University of Calgary, the Natural Sciences and Engineering Research Council [CGSD3-559333- 2021], and an honorarium for the methods author work associated with Reviews two and four. RCC is a Senior Advisor NFL Head Neck & Spine Committee VP NOCSAE and Chair Scientific Advisory CommitteeCo-Founder Medical Director Concussion Legacy FoundationRoyalties Houghton Mifflin Harcourt Legal Expert Opinion. JDC National Collegiate Athletic Association payments for expert testimony. National Hockey League (NHL) payments for expert testimony. GAD is a member of the Scientific Committee of the 6th International Conference on Concussion in Sport; anhonorary member of the Australian Football League (AFL) Concussion Scientific Committee; Section Editor, Sport and Rehabilitation, NEUROSURGERY; and has attended meetings organised by sporting organisations including the NFL, National Rugby League (NRL), International Ice Hockey Federation (IIHF), International Olympic Committee (IOC) and Federation International de Football Association (FIFA); however, has not received any payment, research funding or other monies from these groups other than for travel costs. JD has nothing to disclose. RJE is a paid consultant for the NHL and co-chair of the NHL/NHL Players Association (NHLPA) Concussion Subcommittee. He is also a paid consultant and chair of the Major League Soccer concussion committee, and a consultant to the US Soccer Federation. He previously served as a neuropsychology consultant to Princeton University Athletic Medicine and EyeGuide. He is currently a co-Primary Investigator (PI) for a grant funded by the NFL (NFL-Long) through Boston Children’s Hospital. He occasionally provides expert testimony in matters related to mTBI and sports concussion, and occasionally receives honoraria and travel support/reimbursement for professional meetings. PE is a data consultant to the National Hockey League; received an honorarium for the administrative aspects of the reviews. CAE has received external peer-reviewed research funding from Canadian Institutes of Health Research (CIHR), Canada Foundation for Innovation, International Olympic Committee Medical and Scientific Committee, NFL Play Smart Play Safe Program, and World Rugby. She is an Associate Editor of British Journal of Sport Medicine (BJSM) (unpaid) and has received travel and accommodation support for meetings where she has presented. She is an external advisory board member (unpaid) for HitIQ. KAH has nothing to disclose. GI, PhD serves as a scientific advisor for NanoDX®, Sway Operations, LLC, and Highmark, Inc. He has a clinical and consulting practice in forensic neuropsychology, including expert testimony, involving individuals who have sustained mTBIs (including former athletes). He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.). He has received research funding as a principal investigator from the NFL, and subcontract grant funding as a collaborator from the Harvard Integrated Program to Protect and Improve the Health of NFL Players Association Members. He has received research funding from the Wounded Warrior Project™. He acknowledges unrestricted philanthropic support from ImPACT Applications, Inc., the Mooney-Reed Charitable Foundation, Boston Bolts, the National Rugby League, and the Schoen Adams Research Institute at Spaulding Rehabilitation. JJL receives grant/research support from National Institutes of Health (NIH), Department of Defence (DoD) and American Medical Society for Sports Medicine (AMSSM); is a member of the Scientific Advisory Board for Neuronasal, Highmark Innovations, and Quadrant Biosciences; minority stock options in Highmark Innovations and 360 Concussion Care; expert consultant to NCAA. Consults with NFL and NHL teams on athlete care but does not receive any compensation from these organisations; Editorial Board of Journal of Head Trauma Rehabilitation. MM is sport and exercise medicine physician working in private consulting practice. He is the Chief Medical Officer for the Australian Football League (AFL) and an independent consultant to World Rugby. He is a Shareholder of Olympic Park Sports Medicine Centre in Melbourne. He has previously held positions as the senior physician at the Hawthorn Hawks Football Club (AFL) and Chief Executive Officer of the AFL Doctors Association. He has received research grants from the Australian Football League, outside the submitted work. He has received travel support received from the Australian Football League, FIFA and the International Olympic Committee to attend and present at international conferences. Member of the Scientific Committee for the 6th International Conference on Concussion in Sport. Honorary member of the International CISG and an honorary member of the Australian Rugby Union Concussion Advisory Group. MMcC reports research grants from the US NIH, US Department of Defense, US CDC, US Department of Veterans Affairs, Abbott Laboratories, NFL, and NCAA, and consultancy with the Green Bay Packers and Neurotrauma Sciences, Inc. MMcN 1. Chair, Ethics Expert Group, World Antidoping Agency (WADA) (2021–23) (paid) 2. Member, International Boxing Association, Ethics and Integrity Committee, (2021–22; resigned Oct 2022) (paid) 3. Chair, Therapeutic Use Exemption Fairness Committee (2020–) (paid) 4. Member, Steering Group, Sex Segregation in Sport, International Association of Athletics Federations (IAAF)/World Athletics, (2019–20) (unpaid) 5. Member, International Ice Hockey Federation, Ethics and Integrity Committee (2019–21) (paid) 6. Member, International Olympic Committee Consensus Statement Expert Group on Injuries in Children and Adolescents (2017) (unpaid) 7. Member, Ethics Expert Group, WADA (2016–21) (unpaid) 8. Member, International Olympic Committee Consensus Statement Expert Group on Pain Management (2016)) (unpaid). WM is employed as the Chief Medical Officer of the National Hockey League. JP: Editor BJSM (honorarium); Member of World Rugby Concussion Advisory Group (unpaid); Independent Concussion Consultant for World Rugby (fee per consultation); Medical consultant to South African Rugby (unpaid); Co-chair of the Scientific Committee, 6th International Conference on Concussion in Sport (unpaid); Board member of the CISG (unpaid); Scientific Board member, EyeGuideTM (unpaid). ZP has no conflicts of interests to declare. MP declares the following: Consultant, Chief Medical Officer (CMO), Major League Soccer; Senior Advisor, NFL Head, Neck NCAA-CARE-DoD 2.0, ended 2020; Have received honoraria and reimbursement for travel for speaking and conferences attended; Have written chapters for UpToDate, and received royalties for the Netter’s Sports Medicine textbook; Have provided work as an expert for cases involving concussion, team physician and other sports medicine topics. AMR: Stipend for the clerical and administrative aspects of the systematic review. Tonal Strength Institute: Research grant (not specifically related to the present work). Alberta Bone and Joint Strategic Clinical Network: Research grant (not specifically related to the present work). PER has no conflicts of interest to declare. GMS is an owner of a multidisciplinary practice (managing patients with MSK pain disorders). He is a board member of Hockey Calgary (Calgary, AB, Canada) and Chair of the Alberta Association of Physiotherapy. He received funding for the administrative aspects of the writing of two of the systematic reviews that informed the consensus process. KJS has received grant funding from the CIHR, NFL Scientific Advisory Board, International Olympic Committee Medical and Scientific Research Fund, World Rugby, Mitacs Accelerate, University of Calgary, with funds paid to her institution and not to her personally. She is an Associate Editor of BJSM (unpaid), Independent consultant to World Rugby and has received travel and accommodation support for meetings where she has presented. She coordinated the writing of the systematic reviews that informed Amsterdam International Consensus on Concussion in Sport, for which she has received an educational grant to assist with the administrative costs associated with the writing of the reviews (with funds paid to her institution). She is a member of the AFL Concussion Scientific Committee (unpaid position), Brain Canada (unpaid positions) and Board member of the Concussion in Sport Group (CISG)(unpaid). She works as a physiotherapy consultant and treats athletes of all levels of sport from grass roots to professional. JT: Doctoral funding through the CIHR; Jason also received an honorarium for the administrative parts of the review. KOY holds the Ronald and Irene Ward Chair in Pediatric Brain Injury funded by the Alberta Children’s Hospital Foundation. He is a principal investigator on grants from the CIHR, and co-investigator on research grants from CIHR, Brain Canada Foundation, Social Science and Humanities Research Council (Canada), and NFL Scientific Advisory Board. He is the Editor of Neuropsychology, for which he receives an editorial stipend from the American Psychological Association. He chairs the Canadian Concussion Network, which is funded by CIHR. He is a member of the Scientific Advisory Committee for Brain Injury Canada and the National Research Advisory Council for the National Pediatric Rehabilitation Resource Center.

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

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