PICOT Evidence Synthesis Paper Introduction The purpose of this paper is to provide a synthesis of the literature evidence related to our clinical problem. Our diagnosis PICOT question is as follows, “In teenage athletes with a suspected concussion (P) is a neurological exam (I) compared to imaging testing (C) more accurate in diagnosing a concussion (O) immediately after the injury (T)?” According to our research evidence, a concussion diagnosis should be based on a thorough neurological evaluation comprised of a cognitive and balance function assessment. Our evidence literature findings suggest that imaging testing as a primary diagnostic tool is inconclusive for accurately diagnosing a concussion in an adolescent athlete. Synthesis of Evidence …show more content…
In the McCrea et al. (2017) study, QUADAS-2 was the tool utilized to measure the accuracy of the diagnostic studies involved. This research involved 76 neuroimaging, 16 fluid biomarker and 6 genetic composition studies, all of which contained moderate to high level of bias due to low sample size, inadequate participant variation and lack of non-concussed participants to serve as the controlled group. Even though these studies yielded good information and have high potential for clinical use in the near future, they all had low to moderate level of confidence in strength. The reliability of this study is good because experts in the respective research fields analyzed the study results and assessed for content accuracy using the QUADAS-2 rating system. These diagnostic tools aren’t adequate for applicability into clinical practice. The concussion guideline in Mapstone (2016) is of good quality due to low risk bias. The study reliability is credible given that implemented concussion guide was drafted from multiple class III studies conducted by the American Academy of Neurology and it was revised from a prior guide published by the American Academy of Pediatrics. AAN determined that SCAT3 accurately diagnosed a concussion in an athlete with a sensitivity of 64-89% and a specificity of 91-100% and is the standard assessment tool for children younger or older
Strengths Long-standing reputation Provision of quality healthcare Highest rank in patient satisfaction Recipient of Joint Commission accreditation Serving a diverse population Weaknesses Smaller than other four hospitals Decrease in net profit Increase in expenses Significant increase in long-term debt Not-for-profit status Opportunities Changes in government regulations Change in lifestyle Influx of patients due to higher patient satisfaction Cost savings Opening of some outpatient clinics and surgery centers Threats Too much competition
Strengths for Duquesne University would be that it is nationally ranked number 115. This is a number that can beat many competitors and creates benefits for those that attend. Classes that have fewer than twenty students is 40.9% and classes that have fifty or more students is only at 9%.. (http://colleges.usnews.rankingsandreviews.com/best-colleges/duquesne-university-3258/rankings). Duquesne is located in Pittsburgh Pennsylvania and is known to be one of the top places to live in the country. Pittsburgh is considered the most livable and resilient. There is a young crowd that could be an interest for young adults, also this city is considered to be the third safest cities in the states (https://fitt.co/pittsburgh/pittsburgh-best-city/). Religious values are what many people look for to keep that connect they have with their beliefs, having these values instilled in the curriculum could be a benefit view for parents and students.
Melnyk’s Hierarchy of Evidence is a system often use for assigning levels of evidence in nursing by integrates clinical expertise and patient choices with the best available research. It is represented by a pyramid that enumerates the levels of strength of the evidence from 1 to 7, of which level 1 is the higher level. The higher level on the pyramid, the more likelihood that the research is valid; therefore, answering a clinical or practice question. “The systematic review or meta-analysis of randomized controlled trials are at the top of the evidence pyramid and are typically assigned the highest level of evidence, due to the fact that the study design reduces the probability of bias” (Melnyk, 2011). The weakness of the system is that when
Researchers and doctors had little information on the proper management and care of someone who sustained a concussion. There were 2,350 participants in this study, with each player being enrolled in any one of the Ivy League schools, University of Virginia, or University of Pittsburgh. Players who experienced a mild head injury during practice or a game were removed from the field to be examined and assessed for “cognitive and psychosocial dysfunction through the use of neuropsychological techniques and self-reported questionnaires up to four times after injury” (Barth, et al., 1989). In order for a player to be diagnosed with a mild head injury, he must have had either a head contact injury or a complete loss of consciousness that lasted under two minutes and displayed some sort of memory and/or attention deficient. The results of Barth’s study showed that there were 195 documented mild head injuries.
That’s where the advancements in concussion detection and treatment comes into play. According to the article “Advancements in Concussion Prevention, Diagnosis, and Treatment” the writer states “the Centers for Disease Control and Prevention (CDC) reported 207,830 trips to an emergency room annually between 2001 and 2005 due to sports participation injuries” ( “Advancements in Concussion Prevention, Diagnosis, and Treatment | The Sport Journal” ). The report from the CDC shows how many reported sports injuries occur in a short period. However, this does not include the vast number of injuries not reported every year. That is a lot of injuries that go unreported and not cared for. We can help make it to where all kids after a concussion report it and get treated by educating them on the dangers they face if they continue to play as they are and tell them they will be right back to playing after the testing has been completed and they are clear to play again. This is not hard to do it’s just the fact of telling the kids the truth of the matter and them knowing the tests aren’t hard and don’t take long to pass. But the kids need to know this is needed if they want to be able to play for years to come in school and even in
Herring, Stanley A., and Kathleen R. Bell. "Youth Sports Concussions, An Issue of Physical Medicine and Rehabilitation Clinics." Google Books. Ed. George H. Kraft, MD,MS. Elsevier Health Sciences., Nov. 2011. Web. 08 May 2014. .
Concussions are very common. In the United States alone 1.4 million people suffer from concussions annually (Schafer). Researchers studied fifty brains of people who have suffered from concussions t...
Vaughn, Christopher, Gerard Gioia and Maegan Sady. “School Problems following Sports Concussion. Which Children Are at Greatest Risk?” British Journal Of Sports Medicine. 47.5 (2012) : 47-51 Web. 11 Apr. 2014.
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"Incidence of Concussion in High School Football Players of Ohio and Pennsylvania." Journal of Child Neurology. Web. 28 Sept. 2011. .
Everyone has experienced some type of stress in their life. Whether it has been from work, school, or troubles at home, stress is stress. If anyone had played sports in high school, you know the challenge of balancing school and sports. Imagine that stress, then multiply it exponentially. Everyone knows that college is a much more rigorous version of high school. The only reason some athletes made it to college is due to scholarships for their performance on the field. If they don’t perform well on the field, that scholarship might get cut. This makes practicing the athletes main priority. However, college athletes have to concentrate on their grades so they don’t drop out of college. These athletes know they may not make it to the pro’s, so they know they have to have a back up plan. This back up plan is called a college degree. So college athletes have to concentrate both on sports and classes. Sounds kind of challenging. This is why I believe student athletes should be allowed to miss classes occasionally due to their sport. Athletes are under much more stress, are required to attend practices and classes, and complete their homework. This is simply impossible to do, at least for a human. I believe that this is an important topic because it affects all college athletes.
Through sports or through everyday life, concussions tend to happen. An estimated 300 000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States. Sports are second only to motor vehicle crashes as the leading cause of traumatic brain injury among people aged 15 to 24 years. (U.S National Library of Medicine). Coaches and parents often do not go through the right procedures or protocols when dealing with a teenager who has received a blow to the head. The usual questions that are asked when there is a head injury are, “what day is it, what’s the score, and how many fingers am I holding up?” Now these are not poor questions, but these questions alone cannot determine if a person has suffered a concussion. The correct method, which they are now implementing in most professional sports leagues, is for anyone with a head injury to take a legitimate concussion test performed by the team doctor. (WebbMD) At present the symptoms can be hit or miss. After receiving a concussion, research shows that an “estimated 80 to 90% of concussions heal spontaneously in the first 7 to 10 days”. (Barton Straus) But, it is important to remember not to return until all symptoms are
Following behind motor vehicle crashes, traumatic brain injury in sports is the second leading cause of traumatic brain injuries for people fifth-teen to twenty-four years of age. Immense concerns follows given that American football accounts for the highest incidence of concussions (Rowson and Duma 2130). In addition, th...
With over 100 million users, 400 million snapchats sent daily, and 8,796 snapchats sent per second, Snapchat has been made into a multibillion dollar franchise. Snapchat was not meant to be turned into what it has become today. Snapchat, initially called Picaboo, was launched in Evan Spiegel’s dorm room. Spiegel started Picaboo as a school project at Stanford with his peers Robert Murphy and Reggie Brown. It was created to have the ability to send an image and have that same image permanently deleted. When Picaboo was first released it was not able to attract any users. However, today Snapchat is one of the most downloaded applications in the world.
Stocchetti, N., Pagan, F., Calappi, E., Canavesi, K., Beretta, L., Citerio, G., … Colombo, A., (2004). Inaccurate early assessment of neurological severity in head injury. Journal of Neurotrauma, 21(9), 1131-1140. doi:10.1089/neu.2004.21.1131