A Twitter Journal Club

I want to alert you to a very interesting innovation which was instituted at the end of 2016 and will continue into this new year:  the Canadian Academy of Sport and Exercise Medicine (CASEM) Twitter-based journal club.

You read that right — a journal club, on Twitter.

We’re all familiar with journal clubs.  In fact, the fellowship in which I teach (Nationwide Children’s Hospital Sports Medicine) just completed its monthly journal club yesterday, with the fellow (sports medicine physician in training, Jonathan Napolitano) leading the group of doctors through a study published in our January 2017 CJSM: Reliability Testing of the Balance Error Scoring System in Children Between the Ages of 5 and 14.

I recently wrote of the vital, and increasing, importance social media plays in the dissemination of sports medicine research.  A Twitter journal club is an example of that phenomenon.

The CASEM Journal Club just got off the ground at the end of 2016, and had as its first selection another CJSM study: Physical Exam Risk Factors for Lower Extremity Injuries in High School Athletes:  A Systematic Review. Seems like both CASEM and I found this to be particularly intriguing.  To wit, I cajoled the lead author of that study, Jimmy Onate, into recording a podcast with me.  And then he pulled duty on the CASEM Journal Club as the guest author, interacting on Twitter with folks from around the globe.  What a great opportunity — to get to ask the author directly the questions one has after reading his/her study.

The study for this month’s CASEM journal club is the same one we deconstructed in our fellowship yesterday:  the reliability of the BESS in a pediatric population  It hits close to my heart.  As a pediatric sports medicine physician, I see pediatric sports-related concussions by the dozens.  I have had mixed opinions about the BESS test over the years, at least in my young athletes.  Is it the best test of postural stability?  Does it have true ‘content validity’ (does it accurately assess vestibular function post-concussion)?

The group out of the University of Utah doing this month’s study, and the paired investigation they published in November (A Normative Dataset of the Balance Error Scoring System in Children Aged 5 to 14), provide a wealth of useful information for those of using BESS in this young population.

There have been a wealth of studies published on the test properties of the BESS (reliability, validity, responsiveness), but they have mostly if not exclusively been done on older adolescents and adults.  These two studies from Utah looked at a large group (N = 373) of kids, exclusively: from 5 to 14.  They report on the scores one might consider normative when first evaluating a child athlete post concussion, and they report on various measures of reliability (intrarater, interrater, test-retest) and responsiveness [the minimal detectable change (MDC)].

Overall, they report relatively high ICCs (demonstrating a high degree of reliability), no learning effect, and MDCs ranging from 4.6 – 9.6 (depending on the reliability measure being assessed).  All these data are very helpful when interpreting the BESS.

And so, as you head into the weekend:  grab the journal club article [it has been made FREE for the next week], go to the CASEM Journal Club Twitter site, and get ready for 12 noon EST, Sunday January 15, when the learning and fun commence.