Introduction: While recent guidelines have hoped to form consensus regarding management of concussion, it is unclear if they have been effective in conveying this information to the public. Many parents and athletes obtain medical recommendations via the internet. This study aims to evaluate consistency between online resources and guideline statements in post-concussion return to play (RTP) decisions.
Methods: Five websites were selected through a Google search for return to play after concussion. These websites represented a federal government institution (Centers for Disease Control, CDC); a national high school association website (National Federation of State High School Associations, NFHS); a popular nationally-recognized medical website for patients (WebMD); a University hospital (University of Michigan, UM); a popular parent-driven website for sports parents (MomsTeam, MT); as well as a website for a private concussion clinic (Sports Concussion Institute, SCI). The Zurich Sport Concussion Consensus Statement was used as the gold standard for RTP recommendations, and eight specific items identified. Three independent reviewers graded each website for each of the eight recommendations (A=states guideline recommendations appropriately; B=mentions guideline recommendation; C=does not mention guideline recommendation; F=inappropriate recommendation made).
Results: A grade of A was assigned for 45.8% of recommendations, B for 25.0%, C for 25.0%, and F for 4.2%. All websites were assigned grade A for recommendation of no return to play on the day of injury. Only 1 website (WebMD) commented on medication usage in conjunction with the Zurich Statement, and only 2 websites (SCI, UM) commented on management of persistent symptoms. No website correctly commented on all eight guideline recommendations.
Conclusions: Online resources are inconsistent in relaying guideline recommendations for RTP. This is a potential source of confusion in management of concussion for athletes and their parents which may result in inappropriate RTP.
Patient Care: This research will improve patient care by informing providers that online resources can cause confusion in return to play instructions, potentially leading to inappropriate return to play.
Learning Objectives: By the conclusion of this session, participants should be able to identify that online resources are a potential source of confusion in athletes in parents regarding return to play after concussion