Concussion in sport: Saliva test is 94% accurate in rugby union trial
bbc.co.uk
bbc.co.uk
"The test measures expression levels of 14 small noncoding RNAs in saliva, including microRNAs. “MicroRNAs are messages the cells transmit in response to an event, like a brain injury,” Belli tells The Guardian. “The place where you find microRNAs most abundantly is saliva. Salivary glands are connected directly to the brain by nerves. We’re seeing this response within minutes of injury.”
https://www.the-scientist.com/news-opinion/simple-spit-test-...
https://bjsm.bmj.com/content/early/2021/02/09/bjsports-2020-...
Results:
The HIA process confirmed concussion in 106 players (HIA+) and excluded this in 50 (HIA−). 32 sncRNAs were significantly differentially expressed across these two groups, with let-7f-5p showing the highest area under the curve (AUC) at 36–48 hours. Additionally, a combined panel of 14 sncRNAs (let-7a-5p, miR-143-3p, miR-103a-3p, miR-34b-3p, RNU6-7, RNU6-45, Snora57, snoU13.120, tRNA18Arg-CCT, U6-168, U6-428, U6-1249, Uco22cjg1,YRNA_255) could differentiate concussed subjects from all other groups, including players who were HIA− and controls, immediately after the game (AUC 0.91, 95% CI 0.81 to 1) and 36–48 hours later (AUC 0.94, 95% CI 0.86 to 1). When prospectively tested, the panel confirmed high predictive accuracy (AUC 0.96, 95% CI 0.92 to 1 post-game and AUC 0.93, 95% CI 0.86 to 1 at 36–48 hours).
Also, it's not even '"science" reporting', it's "Sport" reporting.
- It helps me believe the website is aware of the source material (vs re-reporting some other news site's content)
- In cases where there are multiple stories over time, it makes it easier to disambiguate which story is about which event. This happens often with legal cases, where there are different judgments from different motions or even from different trials about the same underlying thing. As a lay person, I don't need to understand the source document to be able to understand that three different media outlets are discussing the same document, provided that they each link to the same document
- It decreases the effort for an authority to vet the news story. This sends a signal to me that the organization welcomes such vetting, or at least thinks they'd stand up well to it
I'm just trying to see it from the POV of a reporter or editor desperately trying to avoid getting tasked with a top 10 list article.
Actually, maybe adding actual goddamned references would increase their newsworthiness.
There is also the issue though, that journos/editors aren't experts, and could linking to a paper be construed as endorsing it, when it might turn out to be wrong?
If we find that conclusively to be the case, this kind of test could in fact be more dangerous than no test at all, as athletes (both adults and children) are cleared to continue play after getting "dinged" but not testing positive with a field-side assay such as the one discussed here.
I've always believed that while adults may be able to make their own decisions about risk, children certainly don't have the capacity to choose between looking cool/tough in the moment, having significant cognitive/memory issues in your 30s like my old friend did [0], or worse.
Athletes and parents should continue to be concerned.
[0]: https://www.inquirer.com/philly/sports/20160805_Sielski__Bry...
Rugby, and American Football are only just coming to terms with how dangerous repeated concussions can be. I can't speak for American Football, but for rugby at least, they're trying to take concussion seriously.
I say trying, because there's still a large impetus in rugby culture to minimise/deny concussion, even more so since the rules changed to try to prevent repeated concussions - if you have a concussion, you can't play for at least 20 days since symptoms abated (in my country), which can make a real difference in a team's performance in a given season if you're their star fly-half[1]/winger[2] (for Americans, kinda like the quarterback in that those positions often define the plays made).
Where I can see this being valuable is in detecting concussions that are either a) subtle enough in symptom to slip past the referee's / team doctor's notice, so picking them up via easy testing can prevent further damage (as a concussion on top of concussion is the worst case scenario) and b) pick up concussions that people are trying to deny because it may harm or hinder the team if they're benched.
I can see easy testing for this bringing benefits to both groups a) and b) even if the b's might not be super happy about it.
[1]: Highlights of Dan Carter, probably the second best fly-half in rugby history: https://www.youtube.com/watch?v=D3UsOzJuq5M [2]: Highlights of Jonah Lomu (RIP), arguably the best winger in rugby history, and an absolute machine: https://www.youtube.com/watch?v=OsXTa7UCGlk
- Individuals with severe injuries (8+) would be detected and could not deny it. You'd rid sports of the trainer who asks how many fingers he's holding up, and the answer is always "two." This is a good thing.
- Individuals with significant injuries (5+) would not be detected and would continue playing, causing perhaps worse outcomes. These injuries are more common, and sports would build up to accept and embrace them, since evidence may take decades to gather that reducing diagnosable concussions is not enough.
The latter case could affect thousands/millions more people, and may in fact be the real metric we should be targeting, rather than the as-currently-defined diagnosable concussion.
Thing is, I doubt a saliva test would ever replace the "Well, he just asked the entire opposing team to marry him and told us he can see the future"[1] detection of concussion, or all the other known symptoms of concussions that referees at the club levels, and team doctors at the professional levels are trained to notice.
So yeah, if this can detect concussions not detectable via current methods, it's a definite win. But I also agree that if it were to replace the existing techniques, it'd be a net loss.
But I believe that, ultimately, the administrators of these sports realise a bunch of brain damaged former players is bad for the sport, so they will use it in a manner that complements, not replaces, existing diagnostic techniques.
[1]: Pretty much how my last concussion went down (thanks rugby league), except it was my teacher and half of my class I asked to marry me before they sent to me the sick bay. The delusions of predicting the future were very much real.
Add football (soccer) to that list: https://www.bbc.com/sport/football/55335979 https://www.theguardian.com/football/2021/mar/04/england-fif...
The changing of the guard in the players' union should be instrumental in getting better protection, after years of stonewalling in the name of protecting salaries.
The strength, speed and pace of play of HS and NCAA is vastly different than the professional level.
For any given sport, the any given team is made up of a analogs of the best player in your state in pre-pro levels. Thats a STARK contrast when playing the game.
The simple answer is there just isn't the money to chase compared to the NFL. The concussions are happening in both high school and college and are much less likely to get reported.
A commercialized concussion test , affordably priced , would make a big impact for amateurs and accident victims alike.
Mostly this test would be useful for ruling out concussion, e.g. letting athletes continue to play contact sports because they "just" got a bang on the head, not a concussion. Hardly a game changer.