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Br J Sports Med. 2013 Jan;47(1):54-9. doi: 10.1136/bjsports-2012-091480. Epub 2012 Nov 23.

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

Author information

  • 1Department of Family Medicine, Faculty of Medicine & Dentistry, Glen Sather Sports Medicine Clinic, Edmonton Clinic, Level 2, 11400 University Avenue, University of Alberta, Edmonton, Alberta, Canada T6G 1Z1. ConnieLebrun@med.ualberta.ca

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.

[PubMed - indexed for MEDLINE]
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