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The results of the first 2 rounds were used to develop a Likert\u2010style questionnaire for round 3. If agreement at round 3 was \u226480% for an item, if panel members were outside consensus or there were &gt;30% neither agree\/disagree responses, the results were carried forward into round 4. The level of agreement and consensus was defined as 90%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Individualized graduated RTS protocols should be used. A normal clinical, ocular and balance examination with no more headaches, and asymptomatic exertional test allows RTS. Earlier RTS can be considered if athletes are symptom free. The Sports Concussion Assessment Tool 5 and vestibular and ocular motor screening are recognized as useful tools to assist in decision\u2010making. Ultimately RTS is a clinical decision. Baseline assessments should be performed at both collegiate and professional level and a combination of neurocognitive and clinical tests should be used. A specific number of recurrent concussions for season\u2014or career\u2010ending decisions could not be determined but will affect decision making for RTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Consensus was achieved for 10 of the 25 RTS criteria: early RTS can be considered earlier than 48 to 72 hours if athletes are completely symptom\u2010free with no headaches, a normal clinical, ocular and balance examination. A graduated RTS should be used but should be individualized. Only 2 of the 9 assessment tools were considered to be useful: Sports Concussion Assessment Tool 5 and vestibular and ocular motor screening. RTS is mainly a clinical decision. Only 31% of the baseline assessment items achieved consensus: baseline assessments should be performed at collegiate and professional levels using a combination of neurocognitive and clinical tests. The panel disagreed on the number of recurrent concussions that should be season\u2010 or career\u2010ending.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level V, expert Opinion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2023.06.027","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T11:43:35Z","timestamp":1688471015000},"page":"460-469","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"title":["Return to Sports Following Sports\u2010Related Concussion in Collision Sports: An Expert Consensus Statement Using the Modified Delphi Technique"],"prefix":"10.1002","volume":"40","author":[{"given":"Erik","family":"Hohmann","sequence":"first","affiliation":[{"name":"Medical School Faculty of Health Sciences University of Pretoria Pretoria South Africa"},{"name":"Department of Orthopaedic Surgery and Sports Medicine"},{"name":"Burjeel Hospital for Advanced Surgery Dubai United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Bloomfield","sequence":"additional","affiliation":[{"name":"CMO Manly Sea Eagles, NRL Team"},{"name":"World Rugby Concussion Consultant"},{"name":"Former CMO National Rugby League Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiri","family":"Dvorak","sequence":"additional","affiliation":[{"name":"Department of Neurology Spine Unit Schulthess Clinic Zurich Switzerland"},{"name":"Former CMO FIFA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben","family":"Echemendia","sequence":"additional","affiliation":[{"name":"Psychological &amp; 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