{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:12:32Z","timestamp":1792818752464,"version":"4.5.0"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec id=\"ab-nsc260001-1\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Concussion is a high-profile and important brain injury, yet the on-pitch assessment of concussion in football (soccer) remains challenging due to the absence of a standardized, evidence-based assessment protocol that can be completed within a time-restrained on-pitch football-match environment. The objective of this study was to develop a football-specific, standardized on-pitch concussion assessment protocol informed by research evidence and expert opinion using an international consensus process and steering committee deliberation, which included medical experts from each of the 6 football confederations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-nsc260001-2\">\n                    <jats:title>Observations<\/jats:title>\n                    <jats:p>Nominated global medical representatives with experience in the on-pitch assessment of concussion in football (\u22655 assessments within previous year) from F\u00e9d\u00e9ration Internationale de Football Association (FIFA)\u2013member associations completed a 2-round Delphi questionnaire to score all identified assessment items that have been used to assess an athlete with a suspected concussion within an on- or off-pitch environment (in any sport) along with expert recommendations. Consensus (\u226580% agreement) was required for assessment items to be included in a football-specific on-pitch concussion assessment protocol. Results demonstrated that from 101 identified assessment items, 41 achieved greater than or equal to 80% agreement for inclusion in round 1, and 6 additional items achieved greater than or equal to 80% agreement in round 2. Four items (scoring 75%-79%) were added after steering committee review. Twelve items were merged to avoid duplication of items that assess the same issue. This resulted in the final Football-Specific Standardized On-Pitch Concussion Assessment Protocol (FOCUS) comprising 45 items categorized into 11 domains as follows: player medical history, mechanism of injury, visible signs, level of consciousness, cervical spine assessment, symptoms, orientation, balance, proprioception, oculomotor function, and activity-based assessment, with each structured for rapid on-pitch evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-nsc260001-3\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>FOCUS provided a standardized, evidence-informed protocol for the on-pitch assessment of a suspected concussion during football match play, addressing a critical gap in player health and safety. Adoption of FOCUS has the potential to harmonize concussion management globally; however, implementation feasibility and diagnostic accuracy require further evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaneurol.2026.2298","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:39:43Z","timestamp":1782920383000},"page":"915","source":"Crossref","is-referenced-by-count":2,"title":["Football-Specific On-Pitch Concussion Assessment Protocol\u2014International Consensus Recommendations"],"prefix":"10.1001","volume":"83","author":[{"given":"Kerry","family":"Peek","sequence":"first","affiliation":[{"name":"FIFA Medical, F\u00e9d\u00e9ration Internationale de Football Association, Zurich, Switzerland"},{"name":"Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, 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