Smartphone and tablet apps for concussion road warriors (team clinicians): a systematic review for practical users
Lee H, Sullivan SJ, Schneiders AG, Ahmed OH, Balasundaram AP, Williams D, Meeuwiss WH, McCrory P. The British Journal of Sports Medicine.2014; ahead of print.
Take Home Message: The SCAT2-1.0.0, SCAT2-1.3.0, and Concussion-1.2.0 are comprehensive apps for trained medical personnel to use for concussion diagnosis and monitoring.
Mobile applications (apps) are increasingly available to help clinicians and the public to detect a possible concussion, especially in instances where a trained medical professional is absent. The quality of the app is dependent on developers, who may not have the knowledge or background to develop a valid app, and currently health care apps are not formally regulated by the US Food and Drug Administration. To help us determine the quality of concussion-related apps it would be helpful to have a formal review of the apps on the market. Therefore, the authors identified and appraised smartphone/tablet apps related to the recognition and assessment of a sports-related concussion. They included apps that were produced in English, designed and/or marketed to be used in the recognition and assessment of concussion, available to sports medicine professionals and/or general public, and a self-contained product. Eighteen apps out of 125 were included in the review. The authors referenced the content of each app to the content of either the Sport Concussion Assessment Tool 2 (SCAT2) if the app was targeted for a trained health care professional, or the Pocket SCAT2 if the app was targeted to the general public. Seventeen out of the eighteen apps were compatible on smart phones and tablets. Most (13/18) were free to download, with the others ranging from US$0.99 to US$44.99. The apps were suitable for a wide range of intended users including: doctors, healthcare professionals, athletic trainers, parents, and coaches. Twelve apps referred to a recognized standard or provided research evidence to support the content of the product. Only 3 apps (i.e., Concusison-1.2.0, SCAT2- 1.0.0, SCAT2-Sport Concussion Assessment tool-1.3.0) had a score 100% when compared to the SCAT2, and just 4 (i.e., the previous 3 apps and Pocket SCAT2) had a score of 83% or higher compared with the Pocket SCAT2.
This is a significant study because it provides the first comparative review of concussion-related mobile apps available to the general public. Smartphones and mobile technologies have created the opportunity to disseminate concussion assessment instrumentation to a wide audience. It is not surprising that the apps with the highest scores were the SCAT2 apps since the SCAT2 test was what the reference. It is interesting to note that the Pocket SCAT2 only scored an 83% compliance, which means that even the apps that have a standard reference need to be improved. It is also essential to note that only the apps designed for trained health care professionals had 100% compliance score. Most of the apps did not include a comprehensive concussion exam. The developers of the apps need to provide the consumer with a well-documented product, and include clear intentions on how the app should be used. Consumers should be critical of what concussion apps they use and ask questions (e.g., who was the intended user, what was the reference used to develop the app). Although these apps are readily available it should be pointed out that the SCAT2 was intended exclusively to be used by trained medical professionals, and should not be looked at as a “do it yourself” approach to medical care.
Questions for Discussion: Do you find concussion assessment apps helpful? If so, which apps do you use?
Written by: Jane McDevitt, PhD
Reviewed by: Jeffrey Driban