Patient-parent Agreement On The Health And Behavior Inventory After Pediatric Concussion: 1510 Board #272 May 30 10:30 AM - 12:00 PM

PURPOSE: The purpose of our study was to examine patient-parent agreement on measures of concussion symptom frequency after pediatric sport-related concussion, and identify differences in patient-parent agreement between child and adolescent age groups. METHODS: We conducted an analysis of data collected from a prospective registry of patients with concussion in a sports medicine clinic. Patients and their parents completed the Health and Behavior Inventory (HBI) at each clinic visit. Wilcoxon signed rank tests were used to assess for potential differences in symptom frequency ratings. Spearman rho correlations and Fisher’s r to z transformation were used to assess linear agreement for total HBI score between parents and children (ages 6-12 yrs), compared to parents and adolescents (ages 13-18 yrs). Multiple regression analyses were used to evaluate the association between parent-reported and patient-reported HBI ratings with return to play (RTP) time and symptom duration. RESULTS: A total of 267 patients (24% children, 28% females, evaluated 8.9±5.2 days post-concussion) were included in the analysis. For total HBI score, the agreement between children and their parents was high (rs=0.88; 95% CI=0.80-0.95). Adolescents also highly agreed with their parents (rs=0.78; 95% CI=0.71-0.85). However, child-parent agreement was significantly higher than adolescent-parent agreement (z=2.21; p=0.03). Additionally, combined child and adolescent patient HBI ratings were significantly associated with symptom resolution time (β=0.296; 95% CI=0.091-0.501; p=0.005) and RTP time (β=0.487; 95% CI = 0.009-0.965; p=0.046), whereas parent HBI ratings were not. CONCLUSIONS: Overall, there was strong agreement between patients and their parents on the HBI, though children demonstrated significantly higher agreement with their parents compared to adolescents. Additionally, patient-reported HBI scores were more predictive of symptom duration and RTP time than parent-reported HBI scores. Clinicians may find this useful when setting expectations regarding concussion symptom duration and RTP timing for patients and their families. Significant reporting discrepancies between patients and their parents may also be a relevant factor for clinicians to consider during acute post-concussion evaluations.