Evidence map›Paper›PMID 23848520›Full record

ArticleJournal of athletic training

Knowledge, attitude, and concussion-reporting behaviors among high school athletes: a preliminary study.

Johna K Register-Mihalik, Kevin M Guskiewicz, Tamara C Valovich McLeod, Laura A Linnan, Frederick O Mueller, Stephen W Marshall

Abstract read
In one paragraph

Article in Journal of athletic training. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 164 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
164citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

164 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  9. The effectiveness of a web-based resource in improving postconcussion management in high schools.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2015
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  19. Sport-Related Concussions in High School Athletes: A Comprehensive Update.Current neurology and neuroscience reports · 2025
    Review
  20. Concussion history and knowledge among top-level youth karate athletes.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2025
    Article

104 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Johna K Register-MihalikEmergency Services Institute, WakeMed Health and Hospitals, Raleigh, NC.
Kevin M Guskiewicz
Tamara C Valovich McLeod
Laura A Linnan
Frederick O Mueller
Stephen W Marshall

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextMany athletes continue to participate in practices and games while experiencing concussion-related symptoms, potentially predisposing them to subsequent and more complicated brain injuries. Limited evidence exists about factors that may influence concussion-reporting behaviors.

objectiveTo examine the influence of knowledge and attitude on concussion-reporting behaviors in a sample of high school athletes.

designCross-sectional study.

settingParticipants completed a validated survey instrument via mail. PATIENTS OR OTHER

participantsA total of 167 high school athletes (97 males, 55 females, 5 sex not indicated; age = 15.7 ± 1.4 years) participating in football, soccer, lacrosse, or cheerleading. INTERVENTION(S): Athlete knowledge and attitude scores served as separate predictor variables. MAIN OUTCOME MEASURE(S): We examined the proportion of athletes who reported continuing to participate in games and practices while symptomatic from possible concussion and the self-reported proportion of recalled concussion and bell-ringer events disclosed after possible concussive injury.

resultsOnly 40% of concussion events and 13% of bell-ringer recalled events in the sample were disclosed after possible concussive injury. Increased athlete knowledge of concussion topics (increase of 1 standard deviation = 2.8 points) was associated with increased reporting prevalence of concussion and bell-ringer events occurring in practice (prevalence ratio [PR] = 2.27, 95% confidence interval [CI] = 1.60, 3.21) and the reporting prevalence of bell-ringer-only events overall (PR = 1.87, 95% CI = 1.38, 2.54). Athlete attitude scores (increase of 1 standard deviation = 11.5 points) were associated with decreases in the proportion of athletes stating they participated in games (PR = 0.74, 95% CI = 0.66, 0.82) and practices (PR = 0.67, 95% CI = 0.59, 0.77) while symptomatic from concussions.

conclusionsMost recalled concussion events in our study were not reported to a supervising adult. Clinicians should be aware that knowledge and attitude influence concussion reporting. Clinicians and administrators should make concussion education a priority and encourage an optimal reporting environment to better manage and prevent concussive injuries in young athletes.

Indexed as

Health Knowledge, Attitudes, PracticeSelf ReportAdolescentAthletic InjuriesBrain ConcussionCross-Sectional StudiesFemaleHumansMalePilot ProjectsSchoolsSportsStudentsSurveys and Questionnaires

Identifiers

PMID23848520
PMCPMC3784366

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.