TABLE 6.
PoCS Rule Performance for Prediction of Secondary Outcomes (90 Days), Validation Cohort
| Delphi definition outcomeβ (n = 602) | Impact on normal activities† (n = 599) | Non-return to work/school‡ (n = 302) | Moderate/severe symptoms§ (n = 599) | |||||
|---|---|---|---|---|---|---|---|---|
| PPCS, n (%) | 113 | (18.8) | 58 | (9.7) | 58 | (19.2) | 74 | (12.4) |
| Using threshold ≥2 points 7 days after trauma | % | 95% CI § | % | 95% CI § | % | 95% CI § | % | 95% CI § |
| Sensitivityα | 88.5 | (82.6-94.4) | 91.4 | (84.2-98.6) | 84.5 | (75.2-93.8) | 97.3 | (93.6-100.0) |
| Specificityα | 45.6 | (41.2-50.0) | 42.7 | (38.5-46.9) | 34.4 | (28.5-40.4) | 44.4 | (40.1-48.6) |
| Negative Predictive Valueα | 94.5 | (91.6-97.4) | 97.9 | (96.0-99.7) | 90.3 | (84.3-96.3) | 99.1 | (98.0-100.0) |
| Positive Predictive Valueα | 27.3 | (22.8-31.9) | 14.6 | (11.0-18.2) | 23.4 | (17.7-29.2) | 19.8 | (15.7-23.9) |
| Using threshold ≥3 points 7 days after trauma | ||||||||
| Sensitivityα | 85.8 | (79.4-92.3) | 91.4 | (84.2-98.6) | 82.8 | (73.0-92.5) | 95.9 | (91.5-100.0) |
| Specificityα | 57.5 | (53.5-61.8) | 54.0 | (49.8-58.2) | 42.6 | (36.4-48.8) | 55.8 | (51.6-60.1) |
| Negative predictive valueα | 94.6 | (92.0-97.2) | 98.3 | (96.9-99.8) | 91.2 | (86.0-96.4) | 99.0 | (97.8-100.0) |
| Positive predictive valueα | 31.8 | (26.6-37.0) | 17.5 | (13.3-21.8) | 25.5 | (19.3-31.8) | 23.4 | (18.7-28.2) |
>α
With 95% confidence interval.
β
As per Lagacé-Legendre and colleagues.86 J Head Trauma Rehabil (2021).
†
PPCS with an impact on normal activities due to head trauma, according to patient.
‡
For those who were worker or student at the time of the mTBI.
§
3 symptoms of 3-4 points using the Rivermead Post-concussion Questionnaire.
POCS, Post-Concussion Symptoms Rule; PPCS, persistent post-concussion symptoms.