Assessment of symptoms in a concussion management programme: Method influences outcome

Context: Monitoring of subjective symptoms is the foundation of all sport concussion management programmes. The purpose of this study is to examine methodological variables that impact symptom reporting during baseline testing. Objective: To investigate how the administration method of a concussion assessment tool (self-report vs interview) affects the report of symptoms. Design, setting and participants: This was a cross-sectional, semi-randomized study of 117 athletes. Main outcome measurements: Subjects completed the Post-Concussion Scale during pre-season evaluations. Results: A two-factor ANOVA revealed a significant difference in total symptom scores (p=0.02) and number of endorsed symptoms (p=0.02) across administration modes. Athletes had a greater total symptom score and reported a greater number of symptoms in the self-administration condition than in the interview condition. Furthermore, there was a significant difference in symptom reporting across interviewer gender. Athletes endorsed more symptoms when the interviewer was a woman. Conclusions: Because the method of collecting symptoms, as well as interviewer gender, can impact test results, self-report measures may be a better way of obtaining consistent results. Clinicians and researchers should be aware that both the nature and extent of symptom reporting is greater when using questionnaires than when athletes are interviewed.