RT Journal Article
SR Electronic
T1 Why screening tests to predict injury do not work—and probably never will…: a critical review
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 776
OP 780
DO 10.1136/bjsports-2016-096256
VO 50
IS 13
A1 Roald Bahr
YR 2016
UL http://bjsm.bmj.com/content/50/13/776.abstract
AB This paper addresses if and how a periodic health examination to screen for risk factors for injury can be used to mitigate injury risk. The key question asked is whether it is possible to use screening tests to identify who is at risk for a sports injury—in order to address the deficit through a targeted intervention programme. The paper demonstrates that to validate a screening test to predict and prevent sports injuries, at least 3 steps are needed. First, a strong relationship needs to be demonstrated in prospective studies between a marker from a screening test and injury risk (step 1). Second, the test properties need to be examined in relevant populations, using appropriate statistical tools (step 2). Unfortunately, there is currently no example of a screening test for sports injuries with adequate test properties. Given the nature of potential screening tests (where test performance is usually measured on a continuous scale from low to high), substantial overlap is to be expected between players with high and low risk of injury. Therefore, although there are a number of tests demonstrating a statistically significant association with injury risk, and therefore help the understanding of causative factors, such tests are unlikely to be able to predict injury with sufficient accuracy. The final step needed is to document that an intervention programme targeting athletes identified as being at high risk through a screening programme is more beneficial than the same intervention programme given to all athletes (step 3). To date, there is no intervention study providing support for screening for injury risk.