Understanding key differences between objective physical measures and cognitive testing in concussion

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“Define what you mean when you say the word ‘screen’ ” has become one of my favorite taglines these past few years.  In the world of concussion screening that aims to prevent secondary injury and inform immediate sideline remove-from-play decisions, there is a huge difference between what is measured when using cognitive tests and an objective physical test.  While cognitive tests measure cognitive function, the authors in a MedPage Today featured article on “Neurocognitive Tests for Concussion” point out differences and drawbacks and highlight what you should know in today’s health arena.  They focus on three examples of objective physical measures include the King-Devick rapid number naming test, electroencephalography, and blood analysis for brain cell-specific biomarkers – all of which provide objective data and physical findings.  A recent paper from Mayo clinic researchers presents an evidence-based argument for why existing popular protocols featuring neurocognitive testing that have historically been used for concussion screening should be viewed as the “wave of the past”.  The article Concussion in Ice Hockey: Current Gaps and Future Directions in an Objective Diagnosis is featured in the Clinical Journal of Sports Medicine and focuses on concussion in ice hockey as an exemplar sport.  It’s an important read and timely for anyone who plays sports, has a family member who plays sports, or works with athletes – and especially for those of us in the clinical and health policy arenas who advocate for the best evidence-based protocols that result in improved health and outcomes.

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