Browsing by Author "Fuller, Gordon W"

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    Correction to: The Use of Sideline Video Review to Facilitate Management Decisions Following Head Trauma in Super Rugby
    (Springer International Publishing, 2018-12-07) Gardner, Andrew J; Kohler, Ryan; McDonald, Warren; Fuller, Gordon W; Tucker, Ross; Makdissi, Michael
    In the original article [1] reference was made to the Hawk-Eye system having been used as the sideline operating system during the 2015 season.
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    Open Access
    Diagnostic Utility of New SCAT5 Neurological Screen Sub-tests
    (2021-02-15) Fuller, Gordon W; Miles, John; Tucker, Ross; Douglas, Marc; Raftery, Martin; Falvey, Eanna; Mathema, Prabhat
    Background The Sports Concussion Assessment Tool (SCAT) is recommended to screen for concussion following head impact events in elite sport. The most recent 5th edition (SCAT5) included a ‘rapid neurological screen’ which introduced new subtests examining comprehension, passive neck movement, and diplopia. This study evaluated the additional diagnostic value of these new subtests. Methods A prospective cohort study was performed in the Pro14 elite Rugby Union competition between September 2018 and January 2020. The SCAT5 was administered by the team doctor to players undergoing off-field screening for concussion during a medical room assessment. Sensitivity, specificity, false negatives, and positives were examined for SCAT5 comprehension, passive neck movement, and diplopia subtests. The reference standard was a final diagnosis of concussion, established by serial standardised clinical assessments over 48 h. Results Ninety-three players undergoing off-field screening for concussion were included. Sensitivity and specificity of the comprehension, passive neck movement, and diplopia subtests were 0, 8, 5% and 0, 91, 97%, respectively (concussion prevalence 63%). No players had any abnormality in comprehension. No players had abnormal passive neck movement or diplopia in the absence of abnormalities in other SCAT5 sub-components. Conclusions The new SCAT5 neurological screen subtests are normal in the majority of players undergoing off-field concussion screening and appear to lack diagnostic utility over and above other SCAT5 subtests.
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    The Use of Sideline Video Review to Facilitate Management Decisions Following Head Trauma in Super Rugby
    (Springer International Publishing, 2018-05-24) Gardner, Andrew J; Kohler, Ryan; McDonald, Warren; Fuller, Gordon W; Tucker, Ross; Makdissi, Michael
    Background Sideline video review has been increasingly used to evaluate risk of concussive injury during match play of a number of collision sports, with the view to reducing the incidence of match play concussion injuries. The purpose of this study was to evaluate the effectiveness of sideline video review for identifying and evaluating head impact events in Rugby Union. Methods All Australian teams’ 2015 Super Rugby season matches were studied. Meaningful head impact events (HIEs) were identified, comprising events identified and acted upon during matches and events identified through a post-season retrospective review. Video footage of each HIE was coded by two experienced independent sports medicine clinicians to evaluate management decisions made by match-day (MDD) and team doctors (TD). HIE incidences for matches with and without sideline video were compared, and the agreement between game-day video interpretation and the independent clinician opinion calculated. Results Seventy HIEs were identified in 83 matches (47 identified during matches and 23 identified post-season), equating to 42.5 HIEs per 1000 player match hours. When video review was available, an unnoticed HIE occurred once every 4.3 matches, compared to once every 2.3 matches when the sideline video review was unavailable. Of the 47 identified in-match HIEs evaluated by TD and MDD during the season, 18 resulted in an immediate and permanent removal, 28 resulted in temporary removal for an off-field assessment, and one resulted in the player continuing the game. Game-day head injury assessment process video decisions agreed with the independent clinician view in 72% of cases, κ = 0.49 (95% CI 0.38–0.59, weak agreement). Conclusions These findings suggest that access to sideline video review is an important supplementary component to identify potential concussions; however, there is a critical need for improved systems and processes to reduce the likelihood of missing an incident.