Social determinants of health and pediatric concussion recovery
Bibliographic record
Abstract
Objective: To examine the relationships between social determinants of health (SDoH) and concussion outcomes in Canadian children. Methods: Secondary analysis of data collected through Advancing Concussion Assessment in Pediatrics (A-CAP), a prospective longitudinal cohort study. Children aged 8 to 16 with concussion (n=633) or orthopedic injury (OI; n=334) were recruited from 5 Canadian pediatric emergency departments. Post-concussion symptoms were measured with the Health and Behavior Inventory weekly for 3 months and biweekly from 3 to 6 months post-injury. Associations between SDoH (i.e., race, household income, parental education, insurance status, neighborhood deprivation) and their interactions with time and post-concussion symptom severity were assessed with linear mixed-effects models. Interactions between household-level and neighborhood-level SDoH and the joint impact of all SDoH were assessed with generalized linear models at 3-months post-injury. Results: Individual SDoH (race, parental education, neighborhood deprivation but not household income or insurance status) were associated with modest differences in post-injury somatic symptom reporting. Similar but weaker (and not statistically significant) patterns were observed for child- and parent- reported cognitive symptoms. Considering all SDoH together contributed to the prediction of injury outcome over and above injury type (concussion vs OI) and known prognostic factors (5P risk score) for three (child-reported cognitive and somatic and parent-reported somatic symptoms) out of the four outcomes at 3-months post-injury. The hypothesis that household and neighborhood metrics of SDoH interact, such that neighborhood deprivation only impacts post-concussion outcomes for children from disadvantaged households, was not supported. Conclusions: Individual SDoH may subtly influence recovery following concussion in Canadian children, but the joint impact of multiple SDoH likely has a stronger effect on recovery.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".