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Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED

Overview of attention for article published in JAMA: Journal of the American Medical Association, March 2016
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (92nd percentile)

Mentioned by

news
21 news outlets
blogs
12 blogs
policy
3 policy sources
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205 X users
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1 patent
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17 Facebook pages
googleplus
1 Google+ user

Citations

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645 Dimensions

Readers on

mendeley
624 Mendeley
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Title
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED
Published in
JAMA: Journal of the American Medical Association, March 2016
DOI 10.1001/jama.2016.1203
Pubmed ID
Authors

Roger Zemek, Nick Barrowman, Stephen B. Freedman, Jocelyn Gravel, Isabelle Gagnon, Candice McGahern, Mary Aglipay, Gurinder Sangha, Kathy Boutis, Darcy Beer, William Craig, Emma Burns, Ken J. Farion, Angelo Mikrogianakis, Karen Barlow, Alexander S. Dubrovsky, Willem Meeuwisse, Gerard Gioia, William P. Meehan, Miriam H. Beauchamp, Yael Kamil, Anne M. Grool, Blaine Hoshizaki, Peter Anderson, Brian L. Brooks, Keith Owen Yeates, Michael Vassilyadi, Terry Klassen, Michelle Keightley, Lawrence Richer, Carol DeMatteo, Martin H. Osmond

Abstract

Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n = 2006 in the derivation cohort; n = 1057 in the validation cohort) and 2584 of whom (n = 1701 [85%] in the derivation cohort; n = 883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n = 510 [30.0%] in the derivation cohort and n = 291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.

X Demographics

X Demographics

The data shown below were collected from the profiles of 205 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 624 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Canada 3 <1%
Netherlands 2 <1%
United States 1 <1%
Unknown 618 99%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 88 14%
Researcher 83 13%
Student > Master 63 10%
Other 60 10%
Student > Ph. D. Student 55 9%
Other 162 26%
Unknown 113 18%
Readers by discipline Count As %
Medicine and Dentistry 197 32%
Psychology 68 11%
Neuroscience 57 9%
Nursing and Health Professions 40 6%
Sports and Recreations 34 5%
Other 76 12%
Unknown 152 24%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 385. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 February 2024.
All research outputs
#80,257
of 25,481,734 outputs
Outputs from JAMA: Journal of the American Medical Association
#1,429
of 36,523 outputs
Outputs of similar age
#1,440
of 314,072 outputs
Outputs of similar age from JAMA: Journal of the American Medical Association
#31
of 393 outputs
Altmetric has tracked 25,481,734 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 36,523 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 72.6. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 314,072 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 393 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 92% of its contemporaries.