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CARE Consortium: Baseline performance among U.S. service academy members

Gender and competition level can affect results, study finds

The NCAA-Department of Defense Concussion Assessment, Research and Education Consortium study evaluates college athletes and military cadets alike, and interrogating baseline concussion assessment data from both groups is essential. In a paper recently published in Military Medicine, Kathryn O’Connor, a postdoctoral fellow at the University of Kentucky’s Sanders-Brown Center on Aging, led a team of researchers that examined baseline results among cadets. The team relied on data from three U.S. service academies taking part in the CARE study — Army West Point, Air Force and Coast Guard — where all cadets are required to participate in athletic activity at either the varsity, club or intramural level.

What did the study find?

Small, but important, differences were observed based on both gender and competition level. Cadets who participated in varsity athletics did worse than their intramural and club counterparts on the Standardized Assessment of Concussion, one of five major baseline tests used in the study. And male cadets were twice as likely to report no symptoms at baseline on a pair of the tests (the Sport Concussion Assessment Tool and the Brief Symptom Inventory) than their female counterparts.

What are the implications?

Understanding what variables can influence baseline concussion performance is vital because medical staff rely on those baseline assessments to diagnose injuries and monitor recovery. “If there are nonconcussion factors, like sex and competition level, that change an individual’s performance on these assessments, then these factors might be important to account for when making diagnostic and recovery decisions,” O’Connor said.

What’s next?

While the study determined that some individual characteristics can be associated with baseline concussion assessment performance, it did not conclude whether these factors influence concussion risk or recovery. Additionally, group testing environments have been shown to affect performance on these sorts of tests. “A future study may evaluate whether increases in symptoms at baseline influence concussion risk and/or recovery,” O’Connor said. “Additionally, these findings may be used to improve concussion diagnosis and management by investigating whether accounting for these factors improves our ability to accurately diagnose a concussion.”