By: Irfan Husain & Iltifat Husain MD (@iltifatMD)
Concussion prevention and management has been a hot topic in recent years among both medical professionals and the public-at-large. The discussion took on a life of its own once reports of several former NFL players suffering from a degenerative trauma caused brain injury known as Chronic Traumatic Encephalopathy (CTE) surfaced, while the NFL tried to play the denial game.
CTE is caused by atrophy of select areas of the brain and is diagnosed post-partum under microscopic study. CTE is commonly associated with “memory disturbances, behavioral and personality changes, Parkinsonism, and speech and gait abnormalities”.
The focus of this article is to review the most up to date concussion guidelines developed by leading experts in traumatic brain injury – American Medical Society for Sports Medicine, American Academy of Neurology, and the Zurich Consensus working group – in order to develop criteria for evaluating concussion applications aimed at diagnosis and initial assessment. Based on a summation of recommendations from these groups and evidence based criteria, we will publish an article with recommendations on apps that can be used for concussion assessment.
Since the NFL concussion controversy began, we have seen significant strides in concussion awareness. There has been a spike in research dollars going towards new diagnostic tools like biomarker levels and concussion prevention technology. Among the general public there has been an increase in educational resources provided to parents, players, and coaches, and most importantly a culture change in athletics resulting in new player protection rules and return-to-play guidelines.
Realizing the need for clarity surrounding concussion information, the three organizations mentioned above published position articles within the past year detailing the following topics: definition, risk factors, symptoms, signs, diagnosis/initial evaluation, imaging, management, return to play, long-term effects, and prevention.
After comparing each of their stances on diagnosis/initial assessment, we have created a list of key criteria involved in diagnosis and sideline assessment that has the potential to be translated into a mobile app format.
Based on the above table, we can identify commonalities among the recommendations set by these 3 expert bodies and use these common recommendations to identify important components needed for a mobile concussion application. These key app features are summarized below.