Machine Learning in Modeling High School Sport Concussion Symptom Resolve

Med Sci Sports Exerc. 2019 Jul;51(7):1362-1371. doi: 10.1249/MSS.0000000000001903.


Introduction: Concussion prevalence in sport is well recognized, so too is the challenge of clinical and return-to-play management for an injury with an inherent indeterminant time course of resolve. A clear, valid insight into the anticipated resolution time could assist in planning treatment intervention.

Purpose: This study implemented a supervised machine learning-based approach in modeling estimated symptom resolve time in high school athletes who incurred a concussion during sport activity.

Methods: We examined the efficacy of 10 classification algorithms using machine learning for the prediction of symptom resolution time (within 7, 14, or 28 d), with a data set representing 3 yr of concussions suffered by high school student-athletes in football (most concussion incidents) and other contact sports.

Results: The most prevalent sport-related concussion reported symptom was headache (94.9%), followed by dizziness (74.3%) and difficulty concentrating (61.1%). For all three category thresholds of predicted symptom resolution time, single-factor ANOVA revealed statistically significant performance differences across the 10 classification models for all learners at a 95% confidence interval (P = 0.000). Naïve Bayes and Random Forest with either 100 or 500 trees were the top-performing learners with an area under the receiver operating characteristic curve performance ranging between 0.656 and 0.742 (0.0-1.0 scale).

Conclusions: Considering the limitations of these data specific to symptom presentation and resolve, supervised machine learning demonstrated efficacy, while warranting further exploration, in developing symptom-based prediction models for practical estimation of sport-related concussion recovery in enhancing clinical decision support.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Athletic Injuries / diagnosis
  • Athletic Injuries / physiopathology*
  • Attention / physiology
  • Brain Concussion / diagnosis
  • Brain Concussion / physiopathology*
  • Clinical Decision-Making
  • Dizziness / etiology
  • Football / injuries
  • Headache / etiology
  • Humans
  • Machine Learning*
  • Return to Sport
  • Time Factors