+1 Recommend
0 collections
      • Record: found
      • Abstract: found
      • Article: not found

      Do Sideline Tests of Vestibular and Oculomotor Function Accurately Diagnose Sports-Related Concussion in Adults? A Systematic Review and Meta-analysis

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.



          Sports-related concussion (SRC) assessment tools are primarily based on subjective assessments of somatic, cognitive, and psychosocial/emotional symptoms. SRC symptoms remain underreported, and objective measures of SRC impairments would be valuable to assist diagnosis. Measurable impairments to vestibular and oculomotor processing have been shown to occur after SRC and may provide valid objective assessments.


          Determine the diagnostic accuracy of sideline tests of vestibular and oculomotor dysfunction to identify SRC in adults.

          Study Design:

          Systematic review; Level of evidence, 4.


          Electronic databases and gray literature were searched from inception until February 12, 2020. Physically active individuals (>16 years of age) who participated in sports were included. The reference standard for SRC was a combination of clinical signs and symptoms (eg, the Sport Concussion Assessment Tool [SCAT]), and index tests included any oculomotor assessment tool. The QUADAS tool was used to assess risk of bias, with the credibility of the evidence being rated according to GRADE.


          A total of 8 studies were included in this review. All included studies used the King-Devick test, with no other measures being identified. Meta-analysis was performed on 4 studies with a summary sensitivity and specificity of 0.77 and 0.82, respectively. The overall credibility of the evidence was rated as very low.


          Caution must be taken when interpreting these results given the very low credibility of the evidence, and the true summary sensitivity and specificity may substantially differ from the values calculated within this systematic review. Therefore, we recommend that clinicians using the King-Devick test to diagnose SRC in adults do so in conjunction with other tools such as the SCAT.

          PROSPERO Registration:


          Related collections

          Most cited references31

          • Record: found
          • Abstract: not found
          • Article: not found

          Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials

            • Record: found
            • Abstract: found
            • Article: not found

            The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews

            Background In the era of evidence based medicine, with systematic reviews as its cornerstone, adequate quality assessment tools should be available. There is currently a lack of a systematically developed and evaluated tool for the assessment of diagnostic accuracy studies. The aim of this project was to combine empirical evidence and expert opinion in a formal consensus method to develop a tool to be used in systematic reviews to assess the quality of primary studies of diagnostic accuracy. Methods We conducted a Delphi procedure to develop the quality assessment tool by refining an initial list of items. Members of the Delphi panel were experts in the area of diagnostic research. The results of three previously conducted reviews of the diagnostic literature were used to generate a list of potential items for inclusion in the tool and to provide an evidence base upon which to develop the tool. Results A total of nine experts in the field of diagnostics took part in the Delphi procedure. The Delphi procedure consisted of four rounds, after which agreement was reached on the items to be included in the tool which we have called QUADAS. The initial list of 28 items was reduced to fourteen items in the final tool. Items included covered patient spectrum, reference standard, disease progression bias, verification bias, review bias, clinical review bias, incorporation bias, test execution, study withdrawals, and indeterminate results. The QUADAS tool is presented together with guidelines for scoring each of the items included in the tool. Conclusions This project has produced an evidence based quality assessment tool to be used in systematic reviews of diagnostic accuracy studies. Further work to determine the usability and validity of the tool continues.
              • Record: found
              • Abstract: found
              • Article: not found

              The epidemiology of sport-related concussion.

              Concussions and head injuries may never be completely eliminated from sports. However, with better data comes an improved understanding of the types of actions and activities that typically result in concussions. With this knowledge can come improved techniques and rule changes to minimize the rate and severity of concussions in sports. This article identifies the factors that affect concussion rate. Copyright © 2011 Elsevier Inc. All rights reserved.

                Author and article information

                The American Journal of Sports Medicine
                Am J Sports Med
                SAGE Publications
                July 2022
                August 25 2021
                July 2022
                : 50
                : 9
                : 2542-2551
                [1 ]School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
                [2 ]Institute of Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
                [3 ]Murdoch Applied Sports Science (MASS) Laboratory, Discipline of Exercise Science, College of Science Health Engineering and Education, Murdoch University, Perth, Australia
                [4 ]Emergency Department, St John of God Murdoch Hospital, Murdoch, Western Australia, Australia
                [5 ]Sports Performance Research Institute New Zealand (SPRINZ), Faculty of Health and Environmental Science, Auckland University of Technology, Auckland, New Zealand
                [6 ]Traumatic Brain injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand
                [7 ]School of Science and Technology, University of New England, Armidale, New South Wales, Australia
                [8 ]Department of Athletic Training, University of Northern Iowa, Cedar Falls, Iowa, USA
                [9 ]School of Nursing, Midwifery, Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
                [10 ]SportsMed Subiaco, St John of God Health Care, Subiaco, Western Australia, Australia
                © 2022



                Comment on this article