SPORT CONCUSSION KNOWLEDGE BASE AND CURRENT PRACTICE– A SURVEY OF PHYSICIAN SECTIONS FROM THE ONTARIO MEDICAL ASSOCIATION. Issue 7 (11th March 2014)

• Record Type: Journal Article
• Authors: Lebrun, C; Mrazik, M; Prasad, A; Taylor, T; Jevremovic, T
• Is Part Of: British journal of sports medicine. Volume 48:Issue 7(2014)
• Page Start: 623
• Page End: 623
• Publication Date: 2014-03-11
• Subjects: Sports medicine -- Periodicals; 617.1027
• DOI: 10.1136/bjsports-2014-093494.171
• Languages: English
• ISSNs: 0306-3674

Abstract

Abstract : Background: It is critical that physicians understand concussion management. Objective: Identify practice patterns/knowledge base in two physician populations. Design: On-line survey. Setting: Ontario, Canada. Participants: Physicians from Sections: Sport and Exercise Medicine (SEM), General and Family Practice (SGFP). Interventions: Emailed survey, 2 reminders. Main utcome measurements: Practice patterns/knowledge base, learning methods: current/preferred. Results: Participants : SEM 92/594 (15.5%), SGFP 270/12, 168 (2.2%); urban practice (90.2% SEM, 71.5% SFGP; P<.001). In preceding 3 months, 84.8% of SEM and 65.6% of SFGP had managed patients with concussion. More SEM than SGFP physicians saw >5 children under 18 with concussions per month (40.2% SEM, 9.5% SGFP; P<001). Tools: Clinical examination (92.4% SEM, 93.7% SFGP); Sport Concussion Assessment Tool (SCAT/SCAT2) (68.4% SEM, 34.1% SFGP; P<.001); balance testing (56.5% SEM, 37.4% SFGP; P=.001); computerized neurocognitive testing (23.9% SEM, 1.9% SFGP; P<.001); concussion grading scales (9.8% SEM, 14.1% SFGP; P<.001). Management: Complete physical rest (65.2% SEM, 68.5% SFGP); absolute cognitive rest (46.7% SEM, 51.9% SFGP); modified school/work until symptom resolution (50.0% SEM, 38.5% SFGP; P=.026); no cognitive rest (3.2% SEM, 9.6% SGFP; P=.026). Return-to-play : Clinical examination (87.0% SEM, 82.6% SFGP); SCAT/SCAT2 (60.8% SEM, 29.6% SFGP; P<.001); balance testing (56.5% SEM, 37.4% SFGP; P<.001); computerized neurocognitive testing (35.9% SEM, 2.2% SFGP; P<.001); concussion grading scales (7.6% SEM, 9.6% SFGP). Current learning sources: colleagues (55.4% SEM, 27.8% SFGP; P<.001); specialists (33.7% SEM, 23.7% SFGP; P=.030); continuing medical education (CME) courses/conferences (67.4% SEM, 54.7% SFGP; P=.017); journals/publications (48.9% SEM, 25.2% SFGP; P<.001); websites (35.8% SEM, 32.2% SFGP); medical school/residency training (19.6% SEM, 17.4% SFGP). Preferred learning sources: CME courses/conferences (85.9% SEM, 73.9% SFGP; P=.006); websites (35.9% SEM, 47.8%, SFGP; P=.024); medical school/residency training (37.0% SEM, 47.8% SFGP). Conclusions: Gaps exist between consensus-based recommendations regarding concussions and current clinical practice patterns. Enhanced training in medical school/residency and additional CME initiatives are recommended.