Evidence map›Paper›PMID 26457403›Full record

Observational studyJAMA pediatrics2015

Factors Associated With Concussion-like Symptom Reporting in High School Athletes.

Grant L Iverson, Noah D Silverberg, Rebekah Mannix, Bruce A Maxwell, Joseph E Atkins, Ross Zafonte, Paul D Berkner

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in JAMA pediatrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
85citing papers in PubMed, 3 pooled it
13.7field-weighted citation impact, top 1% of its field
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

85 citing papers in PubMed, 3 syntheses or guidelines pooled it, 251 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Memory Perfectionism is Associated with Persistent Memory Complaints after Concussion.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2022
    Trial
  5. Influence of Aerobic Exercise Volume on Postconcussion Symptoms.The American journal of sports medicine · 2021
    Trial
  6. Review
  7. Review
  8. Article
  9. Article
  10. Article
  11. Rumination, but Not Reflection, Predicts the Reporting of Post-concussive Symptoms in a Non-clinical Sample.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2026
    Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Grant L IversonDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts2Spaulding Rehabilitation Hospital, Boston, Massachusetts3MassGeneral Hospital for Children Sports Concussion Program, Boston4Red Sox Foundation and Massachus.
Noah D SilverbergDivision of Physical Medicine and Rehabilitation, University of British Columbia, and GF Strong Rehab Centre, Vancouver, British Columbia, Canada.
Rebekah MannixDivision of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.
Bruce A MaxwellDepartment of Computer Science, Colby College, Waterville, Maine.
Joseph E AtkinsDepartment of Psychology, Colby College, Waterville, Maine.
Ross ZafonteDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts3MassGeneral Hospital for Children Sports Concussion Program, Boston4Red Sox Foundation and Massachusetts General Hospital Home Base Program Boston.
Paul D BerknerHealth Services and Department of Biology, Colby College, Waterville, Maine.
Colby College · USBoston Children's Hospital · USBoston Foundation · USGF Strong Rehabilitation Centre · CASpaulding Rehabilitation Hospital · US

Funding

RESEARCH TRAINING IN PEDIATRIC EMERGENCY MEDICINET32HD040128 · NICHD · CHILDREN'S HOSPITAL BOSTON · PI Kenneth D. Mandl · 2001 to 2026
$5.0M
NICHD NIH HHS T32 HD040128
6 · The paper itself

Abstract

importanceEvery state in the United States has passed legislation for sport-related concussion, making this health issue important for physicians and other health care professionals. Safely returning athletes to sport after concussion relies on accurately determining when their symptoms resolve.

objectiveTo evaluate baseline concussion-like symptom reporting in uninjured adolescent student athletes. DESIGN, SETTING, AND

participantsIn this cross-sectional, observational study, we studied 31 958 high school athletes from Maine with no concussion in the past 6 months who completed a preseason baseline testing program between 2009 and 2013.

resultsSymptom reporting was more common in girls than boys. Most students with preexisting conditions reported one or more symptoms (60%-82% of boys and 73%-97% of girls). Nineteen percent of boys and 28% of girls reported having a symptom burden resembling an International Classification of Diseases, 10th Revision (ICD-10) diagnosis of postconcussional syndrome (PCS). Students with preexisting conditions were even more likely to endorse a symptom burden that resembled PCS (21%-47% for boys and 33%-72% for girls). Prior treatment of a psychiatric condition was the strongest independent predictor for symptom reporting in boys, followed by a history of migraines. For girls, the strongest independent predictors were prior treatment of a psychiatric condition or substance abuse and attention-deficit/hyperactivity disorder. The weakest independent predictor of symptoms for both sexes was history of prior concussions. CONCLUSIONS AND RELEVANCE: In the absence of a recent concussion, symptom reporting is related to sex and preexisting conditions. Consideration of sex and preexisting health conditions can help prevent misinterpretation of symptoms in student athletes who sustain a concussion.

Indexed as

AdolescentAthletesAthletic InjuriesBrain ConcussionCohort StudiesCross-Sectional StudiesFemaleHumansInternational Classification of DiseasesLogistic ModelsMaleNeuropsychological TestsPost-Concussion SyndromeRisk FactorsSchoolsStudents

Identifiers

PMID26457403
PMCPMC5333772
OpenAlexW2097755855

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.