Background and Objectives Following the detection of a suspected concussion, diagnosis by a physician is recommended. The objectives were 1) to determine the level of agreement between detection of a suspected concussion and subsequent physician diagnosis, and 2) to assess the risk associated with situations of disagreement.

Design and Outcomes This is a pilot sub-study of the SHRed Concussions program and reports on sport-related concussions documented before 28/02/2022 in 13–17 year-old participants. Cohen’s kappa (K) was used to examine agreement between detection and the physician’s diagnosis. When other diagnoses were identified, the nature and potential for medical complications were described.

Results Of 166 cases of suspected concussion, 162 concussion diagnoses were confirmed upon initial medical assessment (proportion of agreement 0.976, 95% CI: 0.953–0.999; KAPPA= 0.952). Other diagnoses were identified in 5 cases in which 3 were head or neck injury other than concussion and 2 were concussions with an additional diagnosis. In one case a ‘red flag’ was identified by the physician (increasing headache), leading to brain imaging. Of the 4 cases of disagreement, 3 were considered at low risk of complication and only one presented a higher risk.

Conclusion A high level of agreement between detection and physician diagnosis was observed. One situation associated with a higher risk of complication resulted from failure to review the SCAT5 ‘red flags’ in a situation of assessment that was not ‘immediate or on-field’. This may inform adjustments to the SCAT5 terminology and support further research on the efficient use of medical resources.