Davis et al. (2023). Definition of sport-related concussion: The 6th International Conference on Concussion in Sport. British Journal of Sports Medicine, 57 (11), 617-618. https://doi.org/10.1136/bjsports-2022-106650

  • The Concussion in Sport Group (CISG) proposed a conceptual definition of SRC in 2001. This definition has undergone updates and modifications at subsequent CISG meetings, with the most recent being in Berlin in 2016. In preparation for the 6th International Conference on Concussion in Sport, the scientific committee considered that the Berlin definition may require further modification to align with more recent scientific evidence relating to advances in our understanding of the pathophysiology of SRC.

Hohmann et al. (2024). On-field and pitch-side (sideline) assessment of sports concussion in collision sports: An expert consensus statement using the modified Delphi technique. Arthroscopy, 40(2), 449-459. https://doi.org/10.1016/j.arthro.2023.06.026

  • Conclusion: Consensus was achieved for 85% of the clinical signs indicating concussion. On-field and pitch-side assessment should include the observation of the mechanism, a clinical examination, and cervical spine assessment. Of the 19 signs and red flags requiring removal from play, consensus was reached for 74%. Normal clinical examination and HIA with no signs of concussion allow return to play. Video assessment should be mandatory for professional games but should not replace clinical decision-making. Sports Concussion Assessment Tool, Glasgow Coma Scale, vestibular/ocular motor screening, Head Injury Assessment Criteria 1, and Maddocks questions are useful tools. Guidelines are helpful for non-health professionals.

Davis & Makdissi (2020). Commentary: Sensitivity and specificity of on-field visible signs of concussion in the National Football League. Neurosurgery, 87(3), E296–E297. https://doi.org/10.1093/neuros/nyaa063

  • Conclusion: In the NFL, the diagnosis of concussion cannot be made from on-field visible signs alone. The VS checklist is one part of the comprehensive sideline/acute evaluation of concussion, and the diagnosis remains a multimodal clinical decision.

Davis & Makdissi (2016). Use of video to facilitate sideline concussion diagnosis and management decision-making. Journal of Science and Medicine in Sport, 19(11), 898–902. https://doi.org/10.1016/j.jsams.2016.02.005

  • Conclusion: This study suggests that the implementation of a flowchart model could improve timely assessment of concussion, and it identifies the video signs that should trigger automatic removal from play.

Gardner et al. (2018). The use of sideline video review to facilitate management decisions following head trauma in Super Rugby. Sports Medicine - Open, 4(1), 20. https://doi.org/10.1186/s40798-018-0133-4

  • Conclusion: These findings suggest that access to sideline video review is an important supplementary component to identify potential concussions; however, there is a critical need for improved systems and processes to reduce the likelihood of missing an incident.

Makdissi & Davis (2016). The reliability and validity of video analysis for the assessment of the clinical signs of concussion in Australian football. Journal of Science and Medicine in Sport, 19(10), 859–863. https://doi.org/10.1016/j.jsams.2016.02.015

  • Conclusion: Video analysis may be a useful adjunct to the side-line assessment of a possible concussion. Video analysis however should not replace the need for a thorough multimodal clinical assessment.

Reyes et al. (2022). Visible signs of concussion and cognitive screening in community sports. Journal of Neurotrauma, 39(1–2), 122–130. https://doi.org/10.1089/neu.2020.7425

  • Conclusion: All with positive signs of concussion players observed to have a blank/vacant look demonstrated clinically significant decline on the Standardized Assessment of Concussion (SAC). Detection of visible signs of concussion represents a rapid, real-time method for screening players suspected of concussion in community sports where video technology and medical personnel are rarely present. Consistent with community guidelines, it is recommended that all players with positive signs of concussion be immediately removed from play for further concussion screening.

Davis et al. (2019). International study of video review of concussion in professional sports. British Journal of Sports Medicine, 53(20), 1299–1304. https://doi.org/10.1136/bjsports-2018-099727

  • Conclusion: The use of video analysis in assisting medical staff with the diagnosis or identification of potential concussion is well established across different sports internationally. The diagnostic criteria used and the expertise of the video review personnel are not clearly established, and research efforts would benefit from a collaborative harmonisation across sporting codes.

Davis et al. (2019). International consensus definitions of video signs of concussion in professional sports. British Journal of Sports Medicine, 53(20), 1264–1267. https://doi.org/10.1136/bjsports-2019-100628

  • Conclusion: These video signs and definitions have reached international consensus, are indicated for use by professional sporting bodies and will form the basis for further collaborative research.