{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:45:58Z","timestamp":1790232358251,"version":"4.1.0"},"reference-count":24,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000049","name":"Ontario Neurotrauma Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,3,26]]},"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective is to determine if suspected concussions in elite football are medically assessed according to the International Conferences on Concussion in Sport consensus statement recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Men\u2019s Union of European Football Association (UEFA) Football Championship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All professional football players in the UEFA 2016 Championship Tournament.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Potential concussive events (PCEs) were defined as direct head collision incidents resulting in the athlete being unable to immediately resume play following impact. PCEs identified and description of PCE assessment and outcome were accomplished through direct standardised observation of video footage by trained observers in 51 games played in the Men\u2019s UEFA European Championship (10 June\u201310 July 2016).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty-nine total PCEs (1.35 per match) were identified in 51 games played during the 2016 Men\u2019s UEFA European Championship. Forty-eight PCEs (69.6%) resulted in two observable signs of concussion, 13 (18.8%) resulted in three signs and 1 (1.4%) resulted in four signs in the injured athletes. Nineteen (27.5%) PCEs were medically assessed by sideline healthcare personnel while 50 (72.5%) were not. Of the 50 PCEs that were not medically assessed, 44 (88%) PCEs resulted in two or more signs of concussion among injured athletes. Of the 19 medically assessed PCEs, 8 resulted in 3 signs of concussion, and 1 resulted in 4 signs; all assessments concluded in the same-game return for the injured athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PCEs were frequent events in the 2016 UEFA Euro championship, but were rarely assessed concordant with the International Conferences on Concussion in Sport consensus statement recommendations. There is an imperative need to improve the assessment and management of players suspected of concussion in elite football.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-024607","type":"journal-article","created":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T11:25:14Z","timestamp":1559215514000},"page":"e024607","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Medical assessment of potential concussion in elite football: video analysis of the 2016 UEFA European championship"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6221-4915","authenticated-orcid":false,"given":"Karan Joshua","family":"Abraham","sequence":"first","affiliation":[{"name":"Neurosurgery, St. Michael\u2019s Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Casey","sequence":"additional","affiliation":[{"name":"Neurosurgery, St. Michael\u2019s Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsenije","family":"Subotic","sequence":"additional","affiliation":[{"name":"Neurosurgery, St. Michael\u2019s Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Tarzi","sequence":"additional","affiliation":[{"name":"Neurosurgery, St. Michael\u2019s Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Zhu","sequence":"additional","affiliation":[{"name":"Neurosurgery, St. Michael\u2019s Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D","family":"Cusimano","sequence":"additional","affiliation":[{"name":"Neurosurgery, St. Michael\u2019s Hospital, Toronto, Ontario, Canada"},{"name":"Public Health, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,5,30]]},"reference":[{"key":"2025121407361772000_9.5.e024607.1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2016.99"},{"key":"2025121407361772000_9.5.e024607.2","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000156"},{"key":"2025121407361772000_9.5.e024607.3","doi-asserted-by":"publisher","DOI":"10.1097\/00001199-200609000-00001"},{"key":"2025121407361772000_9.5.e024607.4","first-page":"2624","article-title":"Clinical risk score for persistent postconcussion symptoms among childrenwith acute concussion in the ED (vol 315, pg 1014, 2016)","volume":"315","author":"Zemek","year":"2016","journal-title":"Jama-J Am Med Assoc"},{"key":"2025121407361772000_9.5.e024607.5","doi-asserted-by":"publisher","DOI":"10.1249\/mss.0b013e3180383da5"},{"key":"2025121407361772000_9.5.e024607.6","first-page":"238","article-title":"Sex differences and the incidence of concussions among collegiate athletes","volume":"38","author":"Covassin","year":"2003","journal-title":"J Athl Train"},{"key":"2025121407361772000_9.5.e024607.7","first-page":"270","article-title":"Descriptive epidemiology of collegiate men\u2019s soccer injuries: National collegiate athletic association injury surveillance system, 1988-1989 through 2002-2003","volume":"42","author":"Agel","year":"2007","journal-title":"J Athl Train"},{"key":"2025121407361772000_9.5.e024607.8","doi-asserted-by":"crossref","unstructured":"Kunz M . 265 million playing football. 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