Sport concussion knowledge base, clinical practises and needs for continuing medical education: A survey of family physicians and cross-border comparison

Constance M. Lebrun, Martin Mrazik, Abhaya S. Prasad, B. Joel Tjarks, Jason C. Dorman, Michael F. Bergeron, Thayne A. Munce, Verle D. Valentine

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Context Evolving concussion diagnosis/management tools and guidelines make Knowledge Transfer and Exchange (KTE) to practitioners challenging. Objective Identify sports concussion knowledge base and practise patterns in two family physician populations; explore current/preferred methods of KTE. Design A cross-sectional study. Setting Family physicians in Alberta, Canada (CAN) and North/South Dakota, USA. Participants CAN physicians were recruited by mail: 2.5% response rate (80/3154); US physicians through a database: 20% response rate (109/545). Intervention/instrument Online survey. Main and secondary outcome measures Diagnosis/management strategies for concussions, and current/preferred KTE. Results Main reported aetiologies: sports/recreation (52.5% CAN); organised sports (76.5% US). Most physicians used clinical examination (93.8% CAN, 88.1% US); far fewer used the Sport Concussion Assessment Tool (SCAT1/SCAT2) and balance testing. More US physicians initially used concussion-grading scales (26.7% vs 8.8% CAN, p=0.002); computerised neurocognitive testing (19.8% vs 1.3% CAN; p<0.001) and Standardised Assessment of Concussion (SAC) (21.8% vs 7.5% CAN; p=0.008). Most prescribed physical rest (83.8% CAN, 75.5% US), while fewer recommended cognitive rest (47.5% CAN, 28.4% US; p=0.008). Return-to-play decisions were based primarily on clinical examination (89.1% US, 73.8% CAN; p=0.007); US physicians relied more on neurocognitive testing (29.7% vs 5.0% CAN; p<0.001) and recognised guidelines (63.4% vs 23.8% CAN; p<0.001). One-third of Canadian physicians received KTE from colleagues, websites and medical school training. Leading KTE preferences included Continuing Medical Education (CME) courses and online CME. Conclusions Existing published recommendations regarding diagnosis/management of concussion are not always translated into practise, particularly the recommendation for cognitive rest; predicating enhanced, innovative CME initiatives.

Original languageEnglish (US)
Pages (from-to)54-59
Number of pages6
JournalBritish Journal of Sports Medicine
Volume47
Issue number1
DOIs
StatePublished - Jan 1 2013

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Continuing Medical Education
Knowledge Bases
Family Physicians
Canada
Sports
Physicians
Surveys and Questionnaires
Guidelines
Recreation
Alberta
Postal Service
Medical Schools
Cross-Sectional Studies

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Sport concussion knowledge base, clinical practises and needs for continuing medical education : A survey of family physicians and cross-border comparison. / Lebrun, Constance M.; Mrazik, Martin; Prasad, Abhaya S.; Tjarks, B. Joel; Dorman, Jason C.; Bergeron, Michael F.; Munce, Thayne A.; Valentine, Verle D.

In: British Journal of Sports Medicine, Vol. 47, No. 1, 01.01.2013, p. 54-59.

Research output: Contribution to journalArticle

Lebrun, Constance M. ; Mrazik, Martin ; Prasad, Abhaya S. ; Tjarks, B. Joel ; Dorman, Jason C. ; Bergeron, Michael F. ; Munce, Thayne A. ; Valentine, Verle D. / Sport concussion knowledge base, clinical practises and needs for continuing medical education : A survey of family physicians and cross-border comparison. In: British Journal of Sports Medicine. 2013 ; Vol. 47, No. 1. pp. 54-59.
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abstract = "Context Evolving concussion diagnosis/management tools and guidelines make Knowledge Transfer and Exchange (KTE) to practitioners challenging. Objective Identify sports concussion knowledge base and practise patterns in two family physician populations; explore current/preferred methods of KTE. Design A cross-sectional study. Setting Family physicians in Alberta, Canada (CAN) and North/South Dakota, USA. Participants CAN physicians were recruited by mail: 2.5{\%} response rate (80/3154); US physicians through a database: 20{\%} response rate (109/545). Intervention/instrument Online survey. Main and secondary outcome measures Diagnosis/management strategies for concussions, and current/preferred KTE. Results Main reported aetiologies: sports/recreation (52.5{\%} CAN); organised sports (76.5{\%} US). Most physicians used clinical examination (93.8{\%} CAN, 88.1{\%} US); far fewer used the Sport Concussion Assessment Tool (SCAT1/SCAT2) and balance testing. More US physicians initially used concussion-grading scales (26.7{\%} vs 8.8{\%} CAN, p=0.002); computerised neurocognitive testing (19.8{\%} vs 1.3{\%} CAN; p<0.001) and Standardised Assessment of Concussion (SAC) (21.8{\%} vs 7.5{\%} CAN; p=0.008). Most prescribed physical rest (83.8{\%} CAN, 75.5{\%} US), while fewer recommended cognitive rest (47.5{\%} CAN, 28.4{\%} US; p=0.008). Return-to-play decisions were based primarily on clinical examination (89.1{\%} US, 73.8{\%} CAN; p=0.007); US physicians relied more on neurocognitive testing (29.7{\%} vs 5.0{\%} CAN; p<0.001) and recognised guidelines (63.4{\%} vs 23.8{\%} CAN; p<0.001). One-third of Canadian physicians received KTE from colleagues, websites and medical school training. Leading KTE preferences included Continuing Medical Education (CME) courses and online CME. Conclusions Existing published recommendations regarding diagnosis/management of concussion are not always translated into practise, particularly the recommendation for cognitive rest; predicating enhanced, innovative CME initiatives.",
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