{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,3]],"date-time":"2025-05-03T19:29:34Z","timestamp":1746300574868},"reference-count":19,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"3","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p> BACKGROUND: Decision rules (eg, Canadian computed tomography head rule [CCHR] for adults and Pediatric Emergency Care Applied Research Network [PECARN] rule for children\/adolescents) are used in emergency settings (emergency room [ER] rules) to assess traumatic brain injuries (TBIs). The rules have a high-sensitivity and near-perfect negative predictive value that help to rule out more severe TBI. <\/jats:p><jats:p> CLINICAL QUESTION: Which criteria should be added to the Sport Concussion Assessment Tool 5 (SCAT5) to reach the sensitivity of the ER rules and improve the utility of the SCAT5 for screening for higher-severity head and brain injuries? <\/jats:p><jats:p> KEY RESULTS: We performed a comparative analysis of the SCAT5 with the CCHR and PECARN rules. We compared the presence (yes or no) and comparative \u201cface value\u201d sensitivity (lower, identical, or higher) of the SCAT5 criteria to the ER rules criteria. Loss of consciousness, vomiting, severe\/increasing headache, and seizure are SCAT \u201cred flags\u201d with similar or higher sensitivity compared to ER rules criteria. Five criteria had lower sensitivity or were absent from the SCAT. Emergency room rules include any abnormality on the Glasgow Coma Scale (GCS&lt;15), but only a \u201cdeterioration of the state of consciousness\u201d is considered a \u201cred flag\u201d in the SCAT5. Persistent retrograde amnesia for more than 30 minutes, age&gt;65, severity of the mechanism of injury, and signs of skull fractures are not mentioned in the SCAT5. <\/jats:p><jats:p> CLINICAL APPLICATION: We identified 5 criteria that could inform the evolution the SCAT5 to improve its ability to rule out more severe TBI in a sideline assessment context. J Orthop Sports Phys Ther 2023;53(3):113\u2013119. 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