Annual Trends in Follow-Up Visits for Pediatric Concussion in Emergency Departments and Physicians' Offices

Fridman, Liraz; Scolnik, Michal; Macpherson, Alison; Rothman, Linda; Guttmann, Astrid; Grool, Anne M.; Duque, Daniel Rodriguez; Zemek, Roger

doi:10.1016/j.jpeds.2017.09.018

Cited by 40 publications

(27 citation statements)

References 17 publications

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“…Patients assessed for a concussion were identified using CIHI-DAD, NACRS, and OHIP records between fiscal years 1992 to 2011 (exposed patients), similar to previous studies (see Supplementary Table S1 for code list). 6,7 Only the first occurrence of a concussion, in adolescence, was considered the index date. Using RPDB, all remaining patients in the province of Ontario during the study period (unexposed patients) were assigned a random index date based on the distribution of index dates among the exposed patients.…”

Section: Methodsmentioning

confidence: 99%

Concussion in adolescence and the risk of multiple sclerosis: A retrospective cohort study

et al. 2020

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Background: Physical trauma, specifically concussions sustained during adolescence, has been hypothesized to be a risk factor for multiple sclerosis (MS). Objective: To examine the association between adolescent concussions and future MS diagnosis. Methods: This retrospective study using linked administrative databases from Ontario, Canada, identified 97,965 adolescents (age 11–18 years) who sustained ⩾1 concussion and presented to an emergency department between 1992 and 2011. Cases were matched 1:3 with individuals who had not sustained a concussion based on age, sex, address, and index date. The primary outcome was MS diagnosis, using a validated MS diagnosis definition: ⩾1 hospitalization or ⩾5 physician billings within 2 years. Results: A concussion during adolescence was associated with a significantly increased risk of MS (hazard ratio (HR) = 1.29, p = 0.03). Sex-specific analysis revealed that only males who sustained a concussion in adolescence had a raised risk of MS (HR = 1.41, p = 0.04). Conclusion: This study supports an association between concussions in adolescence and future MS diagnoses, highlighting the potentially serious long-term effects of concussions.

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Section: Methodsmentioning

confidence: 99%

Concussion in adolescence and the risk of multiple sclerosis: A retrospective cohort study

et al. 2020

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“…Despite the increasing burden of concussion among Canadian youth, there are emerging concerns that some patients are not receiving adequate medical care following these injuries. National and international guidelines recommend that youth with a suspected concussion undergo urgent medical assessment and obtain medical clearance prior to returning to full sport activities (46, 50) However, a retrospective population-based study in Ontario from 2003 to 2013 found that only one third of youth sought medical follow-up or clearance following an initial visit for concussion (56). Although the responsibility to provide medical assessment and clearance for youth with concussion generally falls upon primary care providers, surveys conducted among Canadian family medicine physicians, pediatricians and emergency department physicians demonstrate considerable knowledge gaps with a significant proportion failing to provide proper post-injury guidance and care (57–60).…”

Section: Current State Of Concussion Care In Canadamentioning

confidence: 99%

The Potential of Telemedicine to Improve Pediatric Concussion Care in Rural and Remote Communities in Canada

Ellis

Russell

2019

Front. Neurol.

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Concussion is a form of mild traumatic brain injury that affects thousands of Canadian children and adolescents annually. Despite national efforts to harmonize the recognition and management of pediatric concussion in Canada, timely access to primary and specialized care following this injury remains a challenge for many patients especially those who live in rural and remote communities. To address similar challenges facing patients with stroke and other neurological disorders, physicians have begun to leverage advances in telemedicine to improve the delivery of specialized neurological care to those living in medically underserved regions. Preliminary studies suggest that telemedicine may be a safe and cost-effective approach to assist in the medical care of select patients with acute concussion and persistent post-concussion symptoms. Here we provide an overview of telemedicine, teleneurology, the principles of concussion assessment and management, as well as the current state of concussion care in Canada. Utilizing preliminary evidence from studies of telemedicine in concussion and experience from comprehensive systems of care for stroke, we outline steps that must be taken to evaluate the potential of telemedicine-based concussion networks to improve the care of pediatric concussion patients living in underserved rural and remote communities in Canada.

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“…Concussion is a common injury [1,2] (200 per 100,000 [3]) among Canadian children and adolescents that leads to a range of neurobehavioral deficits including combinations of somatic, physical, cognitive, and emotional and behavioral symptoms [4]. These postconcussion symptoms can have a significant impact on the functional participation of youth in daily activities, such as sports, school, as well as family and social activities [3,5,6].…”

Section: Introductionmentioning

confidence: 99%

A Mobile Phone App for the Self-Management of Pediatric Concussion: Development and Usability Testing

Sandhu¹,

Wilson²,

Reed³

et al. 2019

JMIR Hum Factors

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Background Concussion is a common injury among Canadian children and adolescents that leads to a range of neurobehavioral deficits. However, noticeable gaps continue to exist in the management of pediatric concussion, with poor health outcomes associated with the inadequate application of best practice guidelines. Objective The aim of this study was to describe the development and assess the usability of a mobile phone app to aid youth in the self-management of concussion. A secondary objective was to assess the usefulness of the app. Methods An agile user-centered design approach was used to develop the technology, followed by a formative lab-based usability study for assessment and improvement proposals. Youths aged 10 to 18 years with a history of concussion and health care professionals involved in concussion management were recruited. This study included participants performing 12 tasks with the mobile phone app while using the think aloud protocol and the administration of the System Usability Scale (SUS), posttest questionnaire, and a semistructured interview. Results A mobile phone app prototype called NeuroCare , an easily accessible pediatric concussion management intervention that provides easy access to expert-informed concussion management strategies and helps guide youth in self-managing and tracking their concussion recovery, was developed. A total of 7 youths aged between 10 and 18 years with a history of concussion and 7 health care professionals were recruited. The mean SUS score was 81.9, mean task success rates were greater than 90% for 92% (11/12) of the tasks, 92% (11/12) of tasks had a total error frequency of less than 11 errors, and mean task completion times were less than 2 min for 100% of the tasks. Conclusions Results suggest that participants rated this app as highly usable, acceptable to users, and that it may be useful in helping youth self-manage concussion.

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Annual Trends in Follow-Up Visits for Pediatric Concussion in Emergency Departments and Physicians' Offices

Cited by 40 publications

References 17 publications

Concussion in adolescence and the risk of multiple sclerosis: A retrospective cohort study

Concussion in adolescence and the risk of multiple sclerosis: A retrospective cohort study

The Potential of Telemedicine to Improve Pediatric Concussion Care in Rural and Remote Communities in Canada

A Mobile Phone App for the Self-Management of Pediatric Concussion: Development and Usability Testing

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