PilotThe Journal of head trauma rehabilitation2024

Documenting Compliance and Symptom Reactivity for Ambulatory Assessment Methodology Following Concussion in Adolescents and Young Adults: Feasibility of the Mobile Neurocognitive Health (MNCH) Project.

R J Elbin, Kori J Durfee, Melissa N Womble and 6 others

PMID 38922030

WHAT IT FOUND

Patients aged 13 to 25 with concussion completed about 71% of daily phone surveys over 7 days; the 7:30 AM survey was least completed.

Most said symptoms did not rise much after surveys, and nearly all who rated the app found it easy.

Key findings

01Median compliance was 71% of expected surveys, and completion was lower at 7:30 AM and in the last four days.

02Median symptom reactivity after surveys was 34.49 on a 100-point scale, and 67% reported scores below 50.

03Most participants who completed the acceptability survey agreed the app was easy to use and would encourage a friend, but 18% said it interfered with daily life and 30% said it made symptoms worse.

STILL TO COME

How it was doneWhat they found

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What it does not show

The study did not compare mobile monitoring with usual care, so it cannot show that the app improves concussion assessment or recovery. Reasons for declining participation or exclusion were not reported, which may make compliance look better than it would be in a broader clinic population. Six of 116 enrolled participants were excluded because they completed no surveys or had a smartphone error, leaving 110 analysed. The sample was mostly female, so findings may not generalise well to male patients. Follow-up was only 7 days, so it does not show what happens with longer daily monitoring. Patients enrolled between 1 and 7 days after injury, so some were in acute and some in sub-acute recovery, which may affect compliance and symptom ratings.

Declared interests

The supplied article is marked as supported by N.I.H., Extramural research funding. No author conflict-of-interest statement is included in the supplied text.

The easy way to misread this

Do not read this as proof that daily phone monitoring improves concussion care or that the app is harmless for every patient. The study had no control group, compliance dropped at some times and later in the week, and some participants reported worse symptoms after using the app.

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The study

Participants
110 participants analysed (116 enrolled)
Certainty of evidence
Very low

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    R J Elbin, Kori J Durfee, Melissa N Womble, et al. Documenting Compliance and Symptom Reactivity for Ambulatory Assessment Methodology Following Concussion in Adolescents and Young Adults: Feasibility of the Mobile Neurocognitive Health (MNCH) Project. The Journal of head trauma rehabilitation. 2024.

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