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UBC research aims to make concussion diagnoses more consistent

UBC neuropsychologist Dr. Noah Silverberg has helped create a new standardized approach to diagnosing concussions.
Dr. Noah Silverberg wants to revolutionize how physicians diagnose concussions.

University of British Columbia neuropsychologist Dr. Noah Silverberg says diagnosing concussions may become more consistent in Canada, and across the world, thanks to his research alongside an international group of experts.

“While we’ve made significant progress in creating these diagnostic criteria for mild TBI (traumatic brain injury), the task ahead is to ensure their widespread adoption,” said Silverberg in a statement released by the university May 23.

Teaming up with the Harvard-affiliated Spaulding Rehabilitation Hospital, Silverberg assisted in publishing new diagnostic criteria for concussions, also known as mild TBI.

“Having unified diagnostic criteria for mild TBI can improve the quality and consistency of mild TBI research and clinical care,” noted Silverberg’s study in Archives of Physical Medicine and Rehabilitation.

The problem Silverberg and the experts are trying to solve is the scattered diagnostic criteria that has evolved over the past three decades.

Silverberg’s statement noted how one study applied various sets of existing criteria to 12,000 pediatric cases and found mild TBI could be diagnosed in seven to 99 per cent of the children. As such, the inconsistencies can lead to inequities in managing symptoms and caring for patients.

“Our hope is that this strong consensus will drive a global shift towards adopting these criteria, ultimately improving patient care and research consistency in the field,” said Silverberg.

The ultimate goal of the research is to create standardized practice guidelines and accreditation standards for health-care facilities in Canada and the United States, according to the experts.

Silverberg, an associate professor at the UBC Department of Psychology, was one of many experts from the American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury, which approved the new criteria.

To come to a concussion diagnosis, there must first be a plausible mechanism of injury and this may include one from sports or even domestic violence. Second, there must be either one or more: clinical signs or acute symptoms attributable to brain injury; a clinical or lab finding; or neuroimaging evidence of TBI.

A clinical sign could be loss of consciousness, alteration of mental status, motor coordination problems, among others listed in the study. An acute symptom may include headache, nausea or emotional irritability.

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