The Results Are In

October 10, 2017

The ConTex concussion study has been tracking the number of concussions suffered among 800,000 Texas high school athletes since its launch in December 2016. Run by the University of Texas Southwestern Medical Center and the University Interscholastic League (UIL), the investigation has released initial observations from its concussion registry.

“It is designed to capture all injuries of all participants in UIL competition, males and females,” C. Munro Cullum, PhD, Clinical Neuropsychologist at UT Southwestern Medical Center, told The Houston Chronicle. “We’re enlisting athletic trainers at all the schools that have them to participate. School superintendents need to say that it’s okay for my school to participate, and then we have to get [an athletic] trainer at the school signed up to use the app we’ve developed, entering basic concussion information they would typically be collecting anyway.”

According to SportsDayHS, this project is a voluntary option for schools that choose to participate. It takes about three minutes to log each injury. Based on the data collected so far, girls are affected by concussion more often than boys, and soccer is the top sport for the injury. However, football season hasn’t coincided with the study’s data collection yet.

After athletic trainers enter injury information into the app, an e-mail then asks that athlete’s parents to consent to use the data in the registry. This is where the study has experienced the most trouble so far.

“It’s a several-step process,” Dr. Cullum told The Houston Chronicle. “Right now, we’re working with the UIL to streamline that process a little bit. Some parents are a bit hesitant right now, although any information we collect is de-identified. We’ll never allow any individual to be identified through anything we do with the data.” 

One of the issues is that many parents don’t reply to the e-mail—to grant or deny consent. As a result, researchers don’t know if they are reading or receiving the message or hesitant to allow access to their children’s data.

“It’s an online system that the data is entered into that then generates an e-mail to the parents that allows them to consent,” Jamey Harrison, Deputy Director at the UIL, told The Houston Chronicle. “Do they have this information, and they are choosing not to consent, or are those e-mails going to a spam filter, trash folder, or just getting deleted because they just don’t recognize it?”

Given the study’s tenuous start, SportsDayHS reports that ConTex is now being designated as a quality improvement project rather than human research. This will allow researchers to access more data with less consent required.

“What we’re proposing is to be able to capture some of the information that actually does not require parental consent,” Dr. Cullum told The Houston Chronicle. “We’re trying to expand the data collection and get a subset of data—it’ll be a smaller number of variables, really basic information like numbers of concussions. That really basic stuff will not require parental consent.”

However, increasing parental consent is still a focal point. Athletic trainers who are involved with the registry are asked to contact athletes’ parents to let them know about the study.

“We really need large numbers in order to do this in a way that will be helpful to the athletes and to parents,” Dr. Cullum told The Houston Chronicle. “What this is all about is improving safety. If there’s one region of the state that gets all new protective gear in a particular season, we’d love to know if that had any effect on the rates of concussion for that region. If so, that could become a best practice other regions want to adopt.” 

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