A review of the evidence on adolescent athlete concussion under-reporting: Barriers and facilitators of concussion symptom disclosure
Bibliographic record
Abstract
The under-reporting of concussion symptoms by adolescent athletes is a serious concern. There is a need to review the under-reporting literature, identify successful methods for improving reporting behaviours and to inform directions for future interventions and educational programming. Therefore, the purpose of this systematic review is to examine and synthesize the current literature on sport-related concussion under-reporting in adolescent athletes. The review addresses the following two objectives: 1) What is the evidence for sport-related concussion under-reporting by adolescent athletes; and 2) What are the barriers or facilitators that contribute to under-reporting? Consideration is also given to determine whether concussion under-reporting behaviours differ between male and female athletes, age groups, or type of sport. Six electronic bibliographic databases were searched for eligible articles, and studies were reviewed at the title/abstract level, followed by independent full-text screening. Overall, 5391 articles were screened at the title abstract level, and 205 were eligible for full-text review. Full-text screening and data extraction are ongoing, and study quality was assessed used a mixed methods assessment tool. Results are analyzed using a narrative synthesis approach; this framework takes a non-linear approach to explore, analyze and synthesize the results from the included studies. Findings consider sociocultural aspects of sport that may influence under-reporting behaviours in young athletes, including athlete identity, risk-taking tendencies and normative sport culture.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.099 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.006 |
| Bibliometrics | 0.012 | 0.013 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".