Neurosensory Screening and Symptom Provocation in Pediatric Mild Traumatic Brain Injury.

The sample was too small to detect smaller effects or examine whether non-specific symptom provocation predicted long-term outcomes. Test administrators were not blinded to whether participants were patients or controls. Many children had zero scores: 46 of 146 patients and 72 of 104 controls had zero pre-test symptoms, and 62 of 146 patients and 75 of 104 controls had zero symptom provocation. These zero scores limit how accurately any test can classify individuals. The study was done in emergency department and urgent care settings, and point of care may influence deficits detected. The clinical risk score used for comparison was developed from more acute assessments than those used here. Symptom provocation was calculated as change from pre-test ratings, and results may vary if calculated differently. The four-month analyses included fewer participants than the baseline sample; at the time of investigation, 125 of 146 patients and 89 of 104 controls were eligible for follow-up, and 105 of 146 patients and 83 of 104 controls completed.

No author conflicts of interest are reported in the supplied text. The article is supported by the National Institutes of Health, Extramural.

Do not read the group differences as proof that this exam diagnoses an individual child or predicts poor recovery. Total symptom provocation did not meaningfully improve single-subject classification, and it did not improve prediction of quality of life.