OBJECTIVE This study evaluated sex differences in performance on the Sport Concussion Assessment Tool-5 (SCAT5) Standardized Assessment of Concussion (SAC) and in baseline SCAT5 symptom reporting. It established clinically relevant cut points for low performance on the SAC based on both reliable chance indices (RCIs) and normative performance. This study also evaluated the diagnostic utility of the sex-adjusted SCAT5 SAC for identification of suspected concussion in collegiate athletes. METHOD In total, 671 uninjured collegiate athletes were administered the SCAT5 and 264 of these athletes also completed SCAT5 testing ~1 year later. Fifty-four athletes were administered the SCAT5 after being removed from play due to suspected concussion. Sex differences in cognitive performance and symptom reporting at baseline were evaluated and sex-specific clinically relevant cut points were provided. Chi square and logistic regression models were used to evaluate if SAC performance was a significant predictor of concussion status. RESULTS Female athletes outperformed male athletes on the SCAT 5 SAC and showed minimally higher symptom endorsement. Use of sex-corrected normative data improved performance of the SAC in identification of suspected concussion when a low score cut point was used. Logistic regression models showed that sex-corrected SAC change from baseline (RCI) improved the predictive value of the model after first accounting for other elements of the SCAT5. CONCLUSIONS Present results support the use of sex-specific normative data for the SCAT5 SAC, particularly if using low performance without comparison to a baseline; however, reliable change from a pre-injury baseline may have somewhat higher diagnostic utility.

中文翻译：

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SCAT5 性别差异：规范数据、临床阈值和识别脑震荡的相关性。

目的 本研究评估了运动脑震荡评估工具 5 (SCAT5) 脑震荡标准化评估 (SAC) 和基线 SCAT5 症状报告中的性别差异。它基于可靠机会指数 (RCI) 和规范性表现，为 SAC 的低表现建立了临床相关的切点。本研究还评估了性别调整的 SCAT5 SAC 在识别大学生运动员疑似脑震荡方面的诊断效用。方法 总共有 671 名未受伤的大学生运动员接受了 SCAT5 测试，其中 264 名运动员在约 1 年后也完成了 SCAT5 测试。54 名运动员在因疑似脑震荡而退出比赛后接受了 SCAT5。评估了基线时认知表现和症状报告的性别差异，并提供了性别特定的临床相关切点。卡方和逻辑回归模型用于评估 SAC 表现是否是脑震荡状态的重要预测指标。结果 女运动员在 SCAT 5 SAC 上的表现优于男运动员，并且表现出最低限度的更高症状认可。当使用低分切点时，使用性别校正的规范数据提高了 SAC 在识别疑似脑震荡方面的表现。Logistic 回归模型显示，在首先考虑 SCAT5 的其他元素后，性别校正的 SAC 与基线的变化 (RCI) 提高了模型的预测值。结论 目前的结果支持对 SCAT5 SAC 使用特定性别的规范数据，特别是如果使用低性能而不与基线进行比较；然而，与受伤前基线相比的可靠变化可能具有更高的诊断效用。