• Br J Sports Med · Jan 2013

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

    • Constance M Lebrun, Martin Mrazik, Abhaya S Prasad, B Joel Tjarks, Jason C Dorman, Michael F Bergeron, Thayne A Munce, and Verle D Valentine.
    • Department 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
    • Br J Sports Med. 2013 Jan 1; 47 (1): 54-9.

    ContextEvolving concussion diagnosis/management tools and guidelines make Knowledge Transfer and Exchange (KTE) to practitioners challenging.ObjectiveIdentify sports concussion knowledge base and practise patterns in two family physician populations; explore current/preferred methods of KTE.DesignA cross-sectional study.SettingFamily physicians in Alberta, Canada (CAN) and North/South Dakota, USA.ParticipantsCAN 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.ResultsMain 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.ConclusionsExisting published recommendations regarding diagnosis/management of concussion are not always translated into practise, particularly the recommendation for cognitive rest; predicating enhanced, innovative CME initiatives.

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