Title:Quantifying the value of multidimensional assessment models for acute concussion: an analysis of data from the NCAA-DOD Care Consortium

Journal name: Sports Medicine

Full name, postal address, e-mail, and telephone number of the corresponding author:

Gian-Gabriel P. Garcia,

1205 Beal Ave, Ann Arbor, MI 48109

(734)-647-0872

Full name, department, institution, city, and country of all co-authors

Gian-Gabriel P. Garcia1, Steven P. Broglio2,Mariel S. Lavieri1, Michael McCrea3, Thomas McAllister4, CARE Consortium Investigators

1Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan, USA

2School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA

3Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, WI, USA

4Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA

Electronic Supplementary Appendix S2: Multivariate Analysis Results

The association between concussion and the variables in the limited models are presented in Table 1 for <6 hours and 24-48 hours.

Table 1: Results of limited models for association between risk factors and concussion for <6 hours and 24-48 hours

(a) <6 hours limited models

Variable / Full (-Male Sex) / Full (-Report injury immediately?) / Full (-Removed from play immediately?) / Full (-SAC change score) / Full (-SCAT symptom severity change score) / Full (-SCAT total symptoms raw score) / Full (-BESS change score)
Coefficient (SE) / Coefficient (SE) / Coefficient (SE) / Coefficient (SE) / Coefficient (SE) / Coefficient (SE) / Coefficient (SE)
Intercept / -3.76 (0.40)* / -3.84 (0.47)* / -4.68 (0.53)* / -4.55 (0.53)* / -5.15 (0.51)* / -1.45 (0.25)* / -4.52 (0.52)*
Male Sex / NA / 1.08 (0.42)* / 1.01 (0.42)* / 0.99 (0.41)* / 1.33 (0.39)* / 0.01 (0.24) / 1.11 (0.41)*
Report injury immediately? / 1.86 (0.43)* / NA / 1.57 (0.40)* / 1.82 (0.44)* / 1.90 (0.41)* / 0.76 (0.25)* / 1.75 (0.42)*
Removed from play immediately? / -0.60 (0.40) / 0.14 (0.35) / NA / -0.54 (0.40) / -0.42 (0.38) / -0.04 (0.26) / -0.69 (0.39)
SAC change score / -0.15 (0.08)* / -0.15 (0.08) / -0.15 (0.08) / NA / -0.19 (0.07)* / -0.09 (0.05) / -0.18 (0.08)*
SCAT symptom severity change score / 0.14 (0.03)* / 0.13 (0.02)* / 0.13 (0.03)* / 0.14 (0.03)* / NA / 0.26 (0.02)* / 0.13 (0.03)*
SCAT total symptoms raw score / 0.98 (0.09)* / 0.94 (0.08)* / 1.00 (0.09)* / 1.00 (0.09)* / 1.04 (0.08)* / NA / 1.02 (0.09)*
BESS change score / 0.10 (0.03)* / 0.08 (0.03)* / 0.09 (0.03)* / 0.10 (0.03)* / 0.07 (0.03)* / 0.10 (0.02)* / NA

SE, standard error

Change score at a timepoint is computed as: raw score at timepoint - raw score at baseline

NA implies that the variable was not included in the model

*This variable had a p-value < 0.05

(b) 24-48 hours limited models

Variable / Full (-Male Sex) / Full (-Report injury immediately?) / Full (-SAC change score) / Full (-SCAT symptom severity change score) / Full (-SCAT total symptoms raw score) / Full (-BESS raw score)
Coefficient (SE) / Coefficient (SE) / Coefficient (SE) / Coefficient (SE) / Coefficient (SE) / Coefficient (SE)
Intercept / -2.30 (0.30)* / -2.28 (0.32)* / -2.79 (0.35)* / -2.96 (0.34)* / -0.97 (0.23)* / -2.74 (0.29)*
Male Sex / NA / 0.55 (0.26)* / 0.59 (0.26)* / 0.66 (0.26)* / -0.12 (0.18) / 0.55 (0.26)*
Report injury immediately? / 0.73 (0.24)* / NA / 0.76 (0.24)* / 0.80 (0.24)* / 0.36 (0.17)* / 0.75 (0.24)*
SAC change score / -0.14 (0.05)* / -0.14 (0.05)* / NA / -0.14 (0.05)* / -0.12 (0.04)* / -0.13 (0.05)*
SCAT symptom severity change score / 0.08 (0.02)* / 0.07 (0.02)* / 0.07 (0.02)* / NA / 0.20 (0.01)* / 0.07 (0.02)*
SCAT total symptoms raw score / 0.71 (0.05)* / 0.71 (0.06)* / 0.72 (0.06)* / 0.80 (0.06)* / NA / 0.72 (0.06)*
BESS raw score / 0.00 (0.02) / -0.01 (0.02) / -0.01 (0.02) / -0.01 (0.02) / 0.04 (0.01)* / NA

SE, standard error

Change score at a timepoint is computed as: raw score at timepoint - raw score at baseline

NA implies that the variable was not included in that model

*This variable had a p-value < 0.05

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The coefficient values and corresponding p-values for the variables in the raw score models are presented in Table 2.

Table 2:Raw score analog of factors in multivariate logistic regression (raw score model) associated with concussion diagnosis at <6 hours and 24-48 hours

Variable / <6 hours / 24-48 hours
Coefficient (SE) / p-value / Coefficient (SE) / p-value
Intercept / -2.01 (2.44) / 0.41 / -1.49 (1.76) / 0.40
Male Sex / 1.45 (0.42) / 0.00 / 0.75 (0.26) / 0.00
Report injury immediately? / 1.67 (0.41) / 0.00 / 0.82 (0.24) / 0.00
Removed from play immediately? / -0.38 (0.38) / 0.31 / NA / NA
SAC raw score / -0.13 (0.09) / 0.14 / -0.06 (0.06) / 0.34
SCAT symptom severity raw score / 0.33 (0.10) / 0.00 / 0.16 (0.08) / 0.05
SCAT total symptoms raw score / 0.49 (0.17) / 0.00 / 0.55 (0.13) / 0.00
BESS raw score / 0.03 (0.03) / 0.30 / -0.01 (0.02) / 0.57

SE, standard error

NA implies that the variable was not included in the model

The final set of risk factors for the <6 hours and 24-48 hours objective models are presented in Table 3.

Table 3:Objective factors in multivariate logistic regression (objective model) associated with concussion diagnosis at <6 hours and 24-48 hours

Variable / <6 hours / 24-48 hours
Coefficient (SE) / p-value / Coefficient (SE) / p-value
Intercept / -3.59 (1.12) / 0.00 / 8.35 (1.36) / 0.00
Age in years / 0.09 (0.06) / 0.10 / -0.03 (0.05) / 0.59
Report injury immediately? / 0.49 (0.15) / 0.00 / NA / NA
SAC change score / -0.22 (0.03) / 0.00 / NA / NA
SAC raw score / NA / NA / -0.28 (0.03) / 0.00
BESS change score / NA / NA / 0.08 (0.01) / 0.00
BESS raw score / 0.12 (0.01) / 0.00 / NA / NA

SE, standard error

Change score at a timepoint is computed as: raw score at timepoint - raw score at baseline

NA implies that the variable was not included in the model

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