{
  "abstract": "Objective To investigate the prognostic value of the Subgroups for Targeted Treatment (STarT) Screening Tool adapted for concussion (STarT-C) on persistent symptoms and disability at 6–9 months following mild traumatic brain injury (mTBI).Design Secondary analysis of two prospective studies: an observational cohort study in New Zealand and usual care control arm of a clinical trial in Canada (ClinicalTrials.gov Registry ( NCT04704037)).Setting Participants in the New Zealand cohort were recruited from concussion clinics (five sites) and those in the Canadian cohort were recruited from emergency departments/urgent care centres (eight sites).Participants New Zealand participants (n=93, median age 37 years, 60% women) were assessed at median=6 weeks post-injury (T1) and 6 months later (T2). Canadian participants (n=223, median age 38 years, 56% women) were assessed at median=2 weeks (T1) and 6 months later (T2).Main outcome measures Symptoms at T2 were assessed using the validated Rivermead Postconcussion Symptoms Questionnaire (RPQ) and disability using the WHO Disability Assessment Schedule 2.0 12-item Interview.Results In linear regression analyses, the STarT-C predicted symptom burden (R 2=18–36%) and disability (R2=15–18%) at T2 in both cohorts. While the additional prognostic value over and above baseline variables was substantial (delta R2 8–40%), the additional prognostic value over the RPQ at T1 was variable and generally lower (delta R2=1–9%).Conclusion The STarT-C—a brief screening tool—predicted persistent symptoms and disability in adults following mTBI. The incremental prognostic value of the STarT-C over the RPQ may be variable, but regardless, the tool may be useful for identifying those at risk of prolonged recovery who may benefit from early psychological intervention.",
  "authors": [
    {
      "affiliations": [
        "Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada",
        "Centre for Aging SMART at Vancouver Coastal Health, Vancouver, British Columbia, Canada"
      ],
      "name": "Ana Mikolić"
    },
    {
      "affiliations": [
        "Department of Orthopedic Surgery and Musculoskeletal Medicine, University of Otago, Dunedin, New Zealand"
      ],
      "name": "Deborah L Snell"
    },
    {
      "affiliations": [
        "TBI Network, Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand"
      ],
      "name": "Alice Theadom"
    },
    {
      "affiliations": [
        "School of Psychology, Victoria University of Wellington, Wellington, New Zealand"
      ],
      "name": "Josh W Faulkner"
    },
    {
      "affiliations": [
        "Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada"
      ],
      "name": "Roger Zemek"
    },
    {
      "affiliations": [
        "Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada",
        "Centre for Aging SMART at Vancouver Coastal Health, Vancouver, British Columbia, Canada"
      ],
      "name": "Noah D Silverberg"
    }
  ],
  "title": "The prognostic value of a screening tool for psychological risk factors after mild traumatic brain injury: prospective studies in Canada and New Zealand",
  "uid": "077d2955-fda0-59e5-92d7-cf905d143433"
}