Utility of the Military Acute Concussion Evaluation as a screening tool for mild @entity131 in a civilian XXXX population.

@entity1545 @entity1 @entity131 @entity2730 @entity909 @entity2587 @entity130
BACKGROUND: Mild @entity131 (mTBI) constitutes 75% of more than 1.5 million traumatic @entity1545 annually. There exists no consensus on point-of-care screening for mTBI. The Military Acute Concussion Evaluation (MACE) is a quick and easy test used by the US Army to screen for mTBI; however, its utility in civilian @entity130 is unclear. It has two parts: a history section and the Standardized Assessment of Concussion (SAC) score (0-30) previously validated in @entity2587 . As a performance improvement project, our institution sought to evaluate the MACE as a concussion screening tool that could be used by housestaff in a general civilian @entity130 population. METHODS: From June 2013 to May 2014, @entity1 18 years to 65 years old with suspected concussion were given the MACE within 72 hours of admission to our urban Level I @entity130 center. @entity1 with a positive head computed tomography were excluded. Demographic data and MACE scores were recorded in prospect. Concussion was defined as @entity909 and/or posttraumatic @entity2730 ; concussed @entity1 were compared with those nonconcussed. Sensitivity and specificity for each respective MACE score were used to plot a receiver operating characteristic (ROC) curve. An ROC curve area of 0.8 was set as the benchmark for a good screening test to distinguish concussion from nonconcussion. RESULTS: There were 84 concussions and 30 nonconcussed @entity1 . Both groups were similar; however, the concussion group had a lower mean MACE score than the nonconcussed @entity1 . Data analysis demonstrated the sensitivity and specificity of a range of MACE scores used to generate an ROC curve area of only 0.65. CONCLUSION: The MACE showed a lower mean score for individuals with concussion, defined by @entity909 and/or posttraumatic @entity2730 . However, the ROC curve area of 0.65 highly suggests that MACE alone would be a poor screening test for mTBI in a general civilian @entity130 population. LEVEL OF EVIDENCE: Diagnostic study, level II.
