Abstract Details

Title The "Good Old Days" Bias in Pediatric Mild Traumatic Brain Injury

Topic Neural Repair/Rehabilitation

Presentation(s) P04 - (-)

Poster/Presentation
Number 027

Objective

Background BACKGROUND: The "good old days" bias is the tendency for patients to view themselves as healthier and asymptomatic prior to any negative event. This phenomenon has been reported in adult mTBI. As there is no diagnostic test for Post-Concussion Syndrome (PCS) and we rely on patient report of a group of symptoms which are common in normal and unhealthy populations, the "good old days bias" becomes highly relevant.

Design/Methods DESIGN/METHODS: Prospective consecutive cohort of 253 children with mTBI presenting at a paediatric Emergency Department (ED). Primary outcome measurement: Post-Concussion Symptoms Inventory (parent and child). Parents completed the PCSI present in the week BEFORE injury at the acute ED presentation, 1 and 3 months following the injury. Post-injury PCS symptoms were reported at 1 week, 1, 2 and 3 months. Analysis: Repeated measures analysis of covariance.

Results RESULTS: The mean age was 11.2 (SD 4.2) years and 62% were male. Parents endorsed significantly fewer symptoms at the 1 month pre-injury PCS assessment compared to the ED pre-injury assessment, (F (1,252) = 133.04, p<0.001). Symptoms most likely to be under reported were headaches, trouble falling asleep, irritability, and difficulty concentrating. Significant differences were observed in the degree of underestimation PCSI pre-injury scores between asymptomatic and symptomatic children at one month post-injury, F=6.76, p<0.01.

Conclusions CONCLUSIONS: Health care professionals rely on post-concussion symptom reporting in the assessment, diagnosis, and treatment of mTBIs. There is the risk that a clinician, a patient, or a family can over interpret the impact of a mTBI on current functioning. The "good old days bias" should be factored into studies examining outcome following paediatric mild traumatic brain injury. Further research is needed to explore factors which influence this bias.

Authors/Disclosures
Basil Kadoura PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Karen Barlow, MD (University of Calgary)	The institution of Dr. Barlow has received research support from Children's Hospital foundation. The institution of Dr. Barlow has received research support from Motor Accident Insurance Commission. The institution of Dr. Barlow has received research support from University of Queensland.
Hans-Peter Hartung, MD, FAAN (Heinrich Heine University Medical Faculty)	Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS Celgene. Dr. Hartung has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Geneuro. Dr. Hartung has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Hartung has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers Neurology.

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