Can Sport Concussion Assessment Tool (SCAT) Symptom Scores Be Converted to Rivermead Post-concussion Symptoms Questionnaire (RPQ) Scores and Vice Versa? Findings From the Toronto Concussion Study.

Laura Kathleen Langer,Cristina Saverino,Paul Comper,Tharshini Chandra,Elizabeth L Inness,Mark T Bayley,David W Lawrence,Seyed Mohammad Alavinia,Alice Kam,Lesley Ruttan,Alan Tam,Evan Foster

doi:10.3389/fspor.2021.737402

Abstract

Background: The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and the Sports Concussion Assessment Tool (SCAT) are widely used self-report tools assessing the type, number, and severity of concussion symptoms. There are overlapping symptoms and domains, though they are scored differently. The SCAT consists of 22 questions with a 7-point Likert scale for a total possible score 132. The RPQ has 16 questions and a 5-point Likert scale for a total of 64 possible points. Being able to convert between the two scores would facilitate comparison of results in the concussion literature.Objectives: To develop equations to convert scores on the SCAT to the RPQ and vice versa.Methods: Adults (17–85 years) diagnosed with a concussion at a referring emergency department were seen in the Hull-Ellis Concussion and Research Clinic, a rapid access concussion clinic at Toronto Rehab–University Health Network (UHN) Toronto Canada, within 7 days of injury. The RPQ and SCAT symptom checklists as well as demographic questionnaires were administered to all participants at Weeks 1, 2, 3, 4, 5, 6, 7, 8, 12, 16.Results: 215 participants had 1,168 matched RPQ and SCAT assessments. Total scores of the RPQ and the SCAT had a rho = 0.91 (p < 0.001); correlations were lower for sub-scores of specific symptom domains (range 0.74–0.87, p < 0.001 for all domain comparisons). An equation was derived to calculate SCAT scores using the number and severity of symptoms on the RPQ. Estimated scores were within 3 points of the observed total score on the SCAT. A second equation was derived to calculate the RPQ from the proportion weighted total score of the SCAT. This equation estimated corresponding scores within 3 points of the observed score on the RPQ.Conclusions: The RPQ and SCAT symptom checklists total scores are highly correlated and can be used to estimate the total score on the corresponding assessment. The symptom subdomains are also strongly correlated between the 2 scales however not as strongly correlated as the total score. The equations will enable researchers and clinicians to quickly convert between the scales and to directly compare concussion research findings.

Highlights

Concussions, or mild traumatic brain injuries are common injuries (Langer et al, 2021) that represent acute neurophysiological event related to blunt impact or other mechanical energy applied to the head, neck, or body, such as from sudden acceleration, deceleration, or rotational forces (Ontario Neurotrauma Foundation, 2018)
The Rivermead Post Concussion Symptoms Questionnaire (RPQ) was published in 1995 (King et al, 1995) as the first assessment of severity of post-concussion symptoms. It uses a 5-point Likert scale to determine the severity of 16 concussion related symptoms in somatic, cognitive, and emotional domains, with scores ranging from 0 to 64
It is commonly used in concussion research in the general population

Summary

Introduction

Concussions, or mild traumatic brain injuries (mTBIs) are common injuries (Langer et al, 2021) that represent acute neurophysiological event related to blunt impact or other mechanical energy applied to the head, neck, or body (with transmitting forces to the brain), such as from sudden acceleration, deceleration, or rotational forces (Ontario Neurotrauma Foundation, 2018). The Rivermead Post Concussion Symptoms Questionnaire (RPQ) was published in 1995 (King et al, 1995) as the first assessment of severity of post-concussion symptoms. It uses a 5-point Likert scale to determine the severity of 16 concussion related symptoms in somatic, cognitive, and emotional domains, with scores ranging from 0 to 64. It is commonly used in concussion research in the general population. The SCAT consists of 22 questions with a 7-point Likert scale for a total possible score 132. Being able to convert between the two scores would facilitate comparison of results in the concussion literature

Objectives

Methods

Results

Discussion

Conclusion