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Systematic review
SCAT2 and SCAT3 scores at baseline and after sports-related mild brain injury/concussion: qualitative synthesis with weighted means
  1. Roger E Thomas1,
  2. Jorge Alves2,
  3. Marcus M Vaska3,
  4. Rosana Magalhães4
  1. 1Department of Family Medicine, Faculty of Medicine, Health Sciences Centre, University of Calgary, Calgary, Alberta, Canada
  2. 2CEREBRO—Brain Health Center, Braga, Portugal
  3. 3Knowledge Resource Service, Alberta Health Services, Holy Cross Centre, Calgary, Alberta, Canada
  4. 4Clinical Academic Center—Braga, Braga, Portugal
  1. Correspondence to Dr Roger E Thomas; rthomas{at}ucalgary.ca

Abstract

Objective Identify all Sport Concussion Assessment Tool (SCAT2/3) studies, compare baseline and postconcussion results.

Design Systematic review (qualitative synthesis, weighted means).

Data sources 18 databases, 9 grey literature resources searched for SCAT2/3 data; 9150 articles identified, titles/abstracts assessed/data-entry independently by two reviewers.

Eligibility criteria for selecting studies Any studies reporting partial/complete SCAT2/3 data.

Results 21 studies with data (partial/complete data 16 SCAT2 (4087 athletes); 5 SCAT3 (891). Newcastle-Ottawa risk-of-bias scale: studies with maximum possible score of 4, 85% scored 3 or 4; studies with maximum possible score of 6, 75% scored 5 or 6. SCAT2 high schoolers: weighted mean score for symptoms 18.46 (22=no symptoms), Balance Error Scoring System (BESS) 26.14, Standardised Assessment of Concussion (SAC) 26.00 and SCAT2 total 88.63. Collegiate/adults weighted means: symptoms 20.09, BESS 25.54, SAC 27.51 and total SCAT2 91.20. Between-study and within-study variability similar to those of the high schoolers. Limited variability between genders. Only 2 studies report baseline and postconcussion scores and 9 partial scores, but data are too limited to provide weighted average scores.

Conclusions Group mean baseline SCAT scores for high school and collegiate athletes are similar, with minimal gender differences; baseline symptoms show more variability than other components. There are minimal data for elementary students and professionals, no data for adult non-collegiate athletes. Two studies provide preconcussion and postconcussion scores. No data on minimal significant clinical differences to guide players/coaches in withdrawing from a game in progress and deciding when recovery is complete and play can be resumed. The SCAT needs supplementing with clinical and neuropsychological return-to-play assessments.

  • Concussion
  • Measurement
  • Evidence based review
  • Sports

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjsem-2015-000095

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    Footnotes

    • Contributors RET conceived the systematic review, assessed titles and abstracts from the search, entered data into the review, computed data and wrote all drafts of the article. MMV conducted the searches. Titles/abstracts were assessed and data independently entered into the text and tables, and the text was edited and amplified by JA, RM and MMV. All authors agree with the final version of the article.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.