{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:25:30Z","timestamp":1792099530883,"version":"4.4.0"},"reference-count":15,"publisher":"Human Kinetics","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:p>This study\u2019s objective was to identify differences in risk for low energy availability and athletic clearance level by comparing scores on Female Athlete Triad Cumulative Risk Assessment (Triad CRA) and Relative Energy Deficiency in Sport Clinical Assessment Tool (RED-S CAT). A total of 1,000 female athletes aged 15\u201330\u00a0years participating in \u22654\u00a0hr of physical activity\/week for the previous \u22656 months completed an extensive survey assessing health, athletic history, family disease history, and specific Triad\/RED-S risk factors. Retrospective chart review ascertained laboratory and bone mineral density measures. Triad CRA and RED-S CAT were used to assign each athlete\u2019s risk level (low, moderate, and high), and case-by-case comparison measured the level of agreement between the tools. We hypothesized that the tools would generally agree on low-risk athletes and that the tools would be less aligned in the specific elevated risk level (moderate or high). Most of the sample was assigned moderate or high risk for Triad CRA and RED-S CAT (Triad: 54.7% moderate and 7.9% high; RED-S: 63.2% moderate and 33.0% high). The tools agreed on risk for 55.5% of athletes. Agreement increased to 64.3% when only athletes with bone mineral density measurements were considered. In conclusion, Triad CRA and RED-S CAT provide consensus on the majority of athletes at elevated (moderate or high) risk for low energy availability, but have less agreement on the specific risk level assigned.<\/jats:p>","DOI":"10.1123\/ijsnem.2019-0002","type":"journal-article","created":{"date-parts":[[2019,4,29]],"date-time":"2019-04-29T18:08:18Z","timestamp":1556561298000},"page":"569-575","source":"Crossref","is-referenced-by-count":20,"title":["Characterization of Risk Quantification Differences Using Female Athlete Triad Cumulative Risk Assessment and Relative Energy Deficiency in Sport Clinical Assessment Tool"],"prefix":"10.1123","volume":"29","author":[{"given":"Bryan","family":"Holtzman","sequence":"first","affiliation":[{"name":"Boston Children\u2019s Hospital"},{"name":"Perelman School of Medicine at the University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam S.","family":"Tenforde","sequence":"additional","affiliation":[{"name":"Spaulding Rehabilitation Hospital"},{"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allyson L.","family":"Parziale","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E.","family":"Ackerman","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital"},{"name":"Harvard Medical School"},{"name":"Massachusetts General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"100","reference":[{"key":"r1","series-title":"British Journal of Sports Medicine,","first-page":"1","article-title":"Low energy availability surrogates correlate with health and performance consequences of relative energy deficiency in Sport","volume":"0","author":"Ackerman, K.E.","year":"2018","unstructured":"Ackerman, K.E., Holtzman, B., Cooper, K.M., Flynn, E.F., Bruinvels, G., Tenforde, A.S., \u2026 Parziale, A.L. (2018). Low energy availability surrogates correlate with health and performance consequences of relative energy deficiency in Sport. British Journal of Sports Medicine,0,1\u20136. doi:10.1136\/bjsports-2017-098958"},{"key":"r2","article-title":"Data table of BMI-for-age charts","year":"2001","unstructured":"Centers for Disease Control and Prevention. (2001). Data table of BMI-for-age charts. Retrieved from https:\/\/www.cdc.gov\/growthcharts\/html_charts\/bmiagerev.htm#females"},{"key":"r3","series-title":"Swiss Medical Weekly,","first-page":"w14196","article-title":"Iron deficiency in sports\u2014definition, influence on performance and therapy","volume":"145","author":"Clenin, G.","year":"2015","unstructured":"Clenin, G., Cordes, M., Huber, A., Schumacher, Y.O., Noack, P., Scales, J., & Kriemler, S. (2015). Iron deficiency in sports\u2014definition, influence on performance and therapy. Swiss Medical Weekly, 145, w14196. doi:10.4414\/smw.2015.14196"},{"issue":"5","key":"r4","series-title":"Clinical Journal of Sport Medicine,","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1097\/JSM.0b013e3181f3c0fe","article-title":"Return-to-play in sport: A decision-based model","volume":"20","author":"Creighton, D.W.","year":"2010","unstructured":"Creighton, D.W., Shrier, I., Shultz, R., Meeuwisse, W.H., & Matheson, G.O. (2010). Return-to-play in sport: A decision-based model. Clinical Journal of Sport Medicine, 20(5), 379\u2013385. PubMed ID: 20818198 doi:10.1097\/JSM.0b013e3181f3c0fe10.1097\/JSM.0b013e3181f3c0fe"},{"issue":"4","key":"r5","series-title":"British Journal of Sports Medicine,","first-page":"289","article-title":"2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013","volume":"48","author":"De Souza, M.J.","year":"2014","unstructured":"De Souza, M.J., Nattiv, A., Joy, E., Misra, M., Williams, N.I., Mallinson, R.J., \u2026 Expert Panel. (2014). 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013. British Journal of Sports Medicine, 48(4), 289\u2013289. PubMed ID: 24463911 doi:10.1136\/bjsports-2013-093218"},{"issue":"5","key":"r6","series-title":"New England Journal of Medicine,","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1056\/NEJM198408023110501","article-title":"Bone mineral content of amenorrheic and eumenorrheic athletes","volume":"311","author":"Drinkwater, B.L.","year":"1984","unstructured":"Drinkwater, B.L., Nilson, K., Chesnut, C.H., III, Bremner, W.J., Shainholtz, S., & Southworth, M.B. (1984). Bone mineral content of amenorrheic and eumenorrheic athletes. New England Journal of Medicine, 311(5), 277\u2013281. PubMed ID: 6738640 doi:10.1056\/NEJM19840802311050110.1056\/NEJM198408023110501"},{"issue":"3","key":"r7","series-title":"JAMA,","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1001\/jama.1986.03380030082032","article-title":"Bone mineral density after resumption of menses in amenorrheic athletes","volume":"256","author":"Drinkwater, B.L.","year":"1986","unstructured":"Drinkwater, B.L., Nilson, K., Ott, S., & Chesnut, C.H., 3rd. (1986). Bone mineral density after resumption of menses in amenorrheic athletes. JAMA, 256(3), 380\u2013382. PubMed ID: 3723725 doi:10.1001\/jama.1986.0338003008203210.1001\/jama.1986.03380030082032"},{"key":"r8","series-title":"Harrison\u2019s principles of internal medicine","author":"Kasper, D.","year":"2015","unstructured":"Kasper, D., Fauci, A., Hauser, S., Longo, D., Jameson, J., & Loscalzo, J. (2015). Harrison\u2019s principles of internal medicine (19th ed). New York, NY: McGraw-Hill Education."},{"issue":"2","key":"r9","series-title":"Pediatrics,","doi-asserted-by":"publisher","first-page":"e438","DOI":"10.1542\/peds.2011-1676","article-title":"Calculation of expected body weight in adolescents with eating disorders","volume":"129","author":"Le Grange, D.","year":"2012","unstructured":"Le Grange, D., Doyle, P.M., Swanson, S.A., Ludwig, K., Glunz, C., & Kreipe, R.E. (2012). Calculation of expected body weight in adolescents with eating disorders. Pediatrics, 129(2), e438\u2013e446. PubMed ID: 22218841 doi:10.1542\/peds.2011-167610.1542\/peds.2011-1676"},{"issue":"7","key":"r10","series-title":"British Journal of Sports Medicine,","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1136\/bjsports-2014-093502","article-title":"The IOC consensus statement: Beyond the Female Athlete Triad--Relative Energy Deficiency in Sport (RED-S)","volume":"48","author":"Mountjoy, M.","year":"2014","unstructured":"Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., \u2026 Ljungqvist, A. (2014). The IOC consensus statement: Beyond the Female Athlete Triad--Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 48(7), 491\u2013497. doi:10.1136\/bjsports-2014-09350210.1136\/bjsports-2014-093502"},{"issue":"7","key":"r11","series-title":"British Journal of Sports Medicine,","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1136\/bjsports-2014-094371","article-title":"RED-S CAT. Relative Energy Deficiency in Sport (RED-S) Clinical Assessment Tool (CAT)","volume":"49","author":"Mountjoy, M.","year":"2015","unstructured":"Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., \u2026 Ackerman, K. (2015). RED-S CAT. Relative Energy Deficiency in Sport (RED-S) Clinical Assessment Tool (CAT). British Journal of Sports Medicine, 49(7), 417\u2013420. doi: 10.1136\/bjsports-2014-09437110.1136\/bjsports-2014-094371"},{"issue":"11","key":"r12","series-title":"British Journal of Sports Medicine,","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1136\/bjsports-2018-099193","article-title":"IOC author consensus statement update 2018: Relative Energy Deficiency in Sport (RED-S)","volume":"52","author":"Mountjoy, M.","year":"2018","unstructured":"Mountjoy, M., Sundgot-Borgen, J.K., Burke, L.M., Ackerman, K.E., Blauwet, C., Constantini, N., \u2026 Budgett, R. (2018). IOC author consensus statement update 2018: Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 52(11), 687\u2013697 . doi:10.1136\/bjsports-2018-09919310.1136\/bjsports-2018-099193"},{"issue":"10","key":"r13","series-title":"Medicine & Science in Sports & Exercise,","first-page":"1867","article-title":"American College of Sports Medicine position stand. The female athlete triad","volume":"39","author":"Nattiv, A.","year":"2007","unstructured":"Nattiv, A., Loucks, A.B., Manore, M.M., Sanborn, C.F., Sundgot-Borgen, J., Warren, M.P., & American College of Sports Medicine. (2007). American College of Sports Medicine position stand. The female athlete triad. Medicine & Science in Sports & Exercise, 39(10), 1867\u20131882. PubMed ID: 17909417 doi:10.1249\/mss.0b013e318149f111"},{"issue":"2","key":"r14","series-title":"American Journal of Sports Medicine,","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1177\/0363546516676262","article-title":"Association of the Female Athlete Triad Risk Assessment Stratification to the Development of Bone Stress Injuries in Collegiate Athletes","volume":"45","author":"Tenforde, A.S.","year":"2017","unstructured":"Tenforde, A.S., Carlson, J.L., Chang, A., Sainani, K.L., Shultz, R., Kim, J.H., \u2026 Fredericson, M. (2017). Association of the Female Athlete Triad Risk Assessment Stratification to the Development of Bone Stress Injuries in Collegiate Athletes. American Journal of Sports Medicine, 45(2), 302\u2013310. PubMed ID: 28038316 doi:10.1177\/036354651667626210.1177\/0363546516676262"},{"issue":"7","key":"r15","series-title":"Medicine & Science in Sports & Exercise,","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1249\/00005768-199307000-00003","article-title":"The female athlete triad: Disordered eating, amenorrhea, osteoporosis","volume":"25","author":"Yeager, K.K.","year":"1993","unstructured":"Yeager, K.K., Agostini, R., Nattiv, A., & Drinkwater, B. (1993). The female athlete triad: Disordered eating, amenorrhea, osteoporosis. Medicine & Science in Sports & Exercise, 25(7), 775\u2013777. doi:10.1249\/00005768-199307000-0000310.1249\/00005768-199307000-00003"}],"container-title":["International Journal of Sport Nutrition and Exercise Metabolism"],"original-title":[],"link":[{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/ijsnem\/29\/6\/article-p569.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.humankinetics.com\/downloadpdf\/journals\/ijsnem\/29\/6\/article-p569.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.humankinetics.com\/downloadpdf\/journals\/ijsnem\/29\/6\/article-p569.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T02:16:00Z","timestamp":1724292960000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/ijsnem\/29\/6\/article-p569.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,1]]},"references-count":15,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.1123\/ijsnem.2019-0002","relation":{},"ISSN":["1526-484X","1543-2742"],"issn-type":[{"value":"1526-484X","type":"print"},{"value":"1543-2742","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,1]]}}}