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Editorial
December 5, 2016

Health-Related Quality of Life After Concussion: How Can We Improve Management of Care?

Author Affiliations
  • 1Steve Tisch BrainSPORT Program, Brain Injury Research Center, UCLA (University of California, Los Angeles), Los Angeles, California
  • 2Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California
  • 3Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California
  • 4Division of Pediatric Neurology, Department of Pediatrics, Mattel Children’s Hospital–UCLA, Los Angeles, California
  • 5Interdepartment Programs for Neuroscience–UCLA, Los Angeles, California
JAMA Pediatr. 2016;170(12):e162985. doi:10.1001/jamapediatrics.2016.2985

The happiness of your life depends upon the quality of your thoughts.

Marcus Aurelius

In the past 20 years, the number of research articles on the topic of concussion, including sports-related injuries, has risen steeply owing to increased concerns regarding both the acute and prolonged effects of the injury. While the Centers for Disease Control and Prevention estimate that 1.6 to 3.8 million sports-related concussions occur each year, a recently published study by Arbogast et al1 suggests that the current estimated rate of concussion, based on emergency department visits, may significantly underestimate the incidence of concussion, given that only 12% of pediatric concussions (sports- or nonsports-related) present to the emergency department. Accordingly, examination of pediatric concussion outcomes appears to be more important than ever, especially given that many individuals present to an outpatient clinic. Up to this point, most studies related to the outcome of pediatric concussion have examined length of return to play, neurocognitive functioning, and self-reported symptoms as main outcome variables, with findings suggesting that adolescents (relative to younger children and adults) experience the most negative effects of concussion (eg, longer resolution of symptoms).2-4 However, in practice, clinicians have likely observed that patients experience difficulties in everyday life that may not be accounted for by those outcome domains. In this issue of JAMA Pediatrics, Novak et al5 address this important aspect of concussion recovery by exploring a relatively novel outcome variable in the assessment of pediatric concussion, quality of life (QoL).

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