Download Brian Hainline

NCAA UPDATE
Brian Hainline, MD
NCAA Chief Medical Officer
Clinical Professor of Neurology
Indiana University School of Medicine
New York University School of Medicine
Sport Science Institute
Mission: To promote and develop safety,
excellence, and wellness in college
student-athletes, and to foster life-long
physical and mental development.
Sport Science Institute
Vision: To be the pre-eminent sport science
voice for all student-athletes and NCAA
member institutions, and to be the
steward of best practices for youth and
intercollegiate sports.
Strategic Agenda
• Phase I:
– Trust.
– Identify Knowledge Gaps.
• Phase II:
– Education.
– “Eptitude.”
• Phase III:
– The NCAA is recognized as the leading Public Health
authority in the sports world.
Knowledge Gaps
Concussion.
Mental health.
Cardiac health.
Overuse & early specialization.
Doping & recreational drug use.
Data analytics & informatics.
Sexual Assault and Interpersonal Violence
Nutrition and Performance
CONCUSSION
Concussion
• We do not understand the natural history of
concussion.
• We do not understand neurobiological
recovery in concussion.
• Solution:
– NCAA-DoD Grand Alliance.
• CARE Consortium.
• Mind Matters Educational Grand Challenge.
– Inter-Association Guidelines and Legislation.
NCAA and DoD Joint Endeavor
• >97% of military TBIs are concussions.
• 85% of military concussions are biomechanically similar to
sport-related concussion.
– 15% are from blast injuries.
• College s-a and military service are similar in age,
athleticism, risk taking and pushing to the edge of
excellence.
• The military theatre is poorly controlled; college sports are
a much more controlled environment.
• Numerous meetings, evaluations, culminating in NCAA-DoD
MOU and CRADA and White House announcement.
Negotiate 8 Contracts and
22 Sub-Contracts
Develop SOPs
Award
Received
Sept 2014
Build CARE Electronic
Data Capture System
and Direct Entry Portal
Launch Website
(www.careconsortium.net)
Submit 24 IRB and HRPO
Applications
Convene 2 Investigator
Meetings
TODAY:
July 2015
Enrolled 7352 CSC and ARC
Athletes/Service Academy Cadets;
Collected 176+ Specimens; Injury Data
on 245 Concussions
Develop CSC, ARC,
and AOC Protocols
and Conduct Training
Executive Committee
Hainline (NCAA), Hack & Rauch (DoD), Koroshetz (NIH)
Concussion Research Initiative
Consortium Operating Committee
Senior Scientific
Advisory Panel
Anderson, Broglio (co-Chair), Clugston, Duma, Giza, Guskiewicz,
McAllister (co-Chair), McCrea (co-Chair), McGinty, Molfese, Putukian
Iverson, Jordan, Kelly, Marshall,
Saykin, Smith, Talavage, Wallace, Xu
Longitudinal Clinical Study
Coordinating Center:
U of Michigan
Broglio (coPI)
Advanced Research
Coordinating Center:
Medical College of Wisconsin
McCrea (coPI)
Administrative
Coordinating Center:
Indiana U School of Medicine
McAllister (coPI)
Advanced Research Core
(ARC)
Longitudinal Clinical Study
Core (CSC)
US Military
Academy
(Independent)
Svoboda & Kelly
U Georgia
(SEC)
Schmidt
U Nebraska
(BIG10)
Molfese
TBD
Year 3
TBD
Year 3
U Oklahoma
(BIG12)
Anderson
U Delaware
(Colonial)
Buckley & Kaminski
Humboldt State
(California
Collegiate)
Ortega
US Air Force
Academy
(Mountain West)
McGinty & Campbell
US Naval Academy
(Independent)
Pyne & Tsao
US Coast Guard
Academy
(New England)
Doria
U Florida
(SEC)
Clugston
U Michigan
(BIG10)
Eckner
TBD
Year 3
U North Carolina
(ACC)
Guskiewicz &
Mihalik
Virginia Tech
(ACC)
Duma & Rowson
U Wisconsin
(BIG10)
Brooks
TBD
Year 3
Princeton
(Ivy)
Putukian
TBD
Year 3
Cal Lutheran
(Southern
California)
Davis
U Pittsburgh
(ACC)
Kontos & Collins
UCLA
(PAC12)
Giza & DiFiori
TBD
Year 3
Azusa Pacific
(Pacific West)
Hoy
Washington
(PAC12)
Chrisman
TBD
Year 3
U Rochester
(University)
Bazarian
TBD
Year 3
TBD
Year 3
CSC & ARC Assessment Protocol
PreSeason
Sub-Acute Concussion
Acute Concussion
Asymptomatic
24-48hrs
/ Cleared for
PostReturn to Play
Injury
Progression
Baseline
<6hrs
PostInjury
Neurocognitive
and Behavioral
Testing (CSC)
X
X
X
X
Blood Biomarker
& DNA Collection
X
X
X
Multi-modal MRI
Studies
O
X
PostConcussion
Unrestricted
7 days
Return to
following
Play
Return to
Play
X
6 Months
Post-Injury
X
X
X
X
X
X
X
X
Head Impact Measurement: HITS (FB) and non-helmeted sensors (FB, SCR, LAX, IH)
Neurobiopsychosocial Model
Multi-Domain Predictor Variables
Neurobiological
Trauma
Burden
Pre-Injury
Factors
- Genetics
- Neurologic
Vulnerabilities
- Injury Severity
- Repetitive
Exposure
- Polytrauma
Psychosocial
Biomarkers
- Structural/
Functional
Imaging
- Blood
Biomarkers
Psychological
Function
Environmental
Factors
Motivational
Factors
- Premorbid
- Post-injury
Comorbidities
- Social Support
- Life Stressors
- Iatrogenesis
- Expectation
- Secondary
Gain
Multi-Dimensional Outcome
Neurologic
Health
Neurocognitive
Function
Neurobehavioral
Function
Psychological
Health and
Wellness
Life Function &
Quality
Advancing the Science of SRC and TBI
McCrea, McAllister & Morey, 2012
Current Status (Sept 11, 2015)
• 13,241 baseline evaluations completed.
– 12,004 unique subjects, 1237 in 2nd year.
• 310 concussions captured.
• All West Point/Air Force cadets registered.
• Developmental stage of youth concussion registry and
rollout of study to youth.
• Developmental stage to extend study to 50+ years (to
become the Framingham study of concussion).
NCAA-DoD Mind Matters
Educational Grand Challenge
Executive Committee
Leadership from NCAA (Hainline), DoD (Hack & Rauch), NIH (Koroshetz)
Educational Grand Challenge
Consortium
(Operating Committee)
NCAA: Amy Dunham, Latrice Sales, Dana Thomas
DoD: Tara Cozzarelli, Stephanie Maxfield-Parker, Kathleen Quinkert
CDC: Kelly Sarmiento
Nine Sigma: Amy Jo Beighley, Denys Resnick, Eloise Young
Immediate Impact Challenge
Long-Term Impact Challenge
Inter-Association Guidelines
www.ncaa.org/concussionsafety
Independent medical care
Year-round practice contact
Concussion diagnosis & management
Endorsements
American Academy of Neurology
American College of Sports Medicine
American Association of Neurological
Surgeons
American Medical Society for Sports
Medicine
American Orthopaedic Society for
Sports Medicine
American Osteopathic Academy for
Sports Medicine
College Athletic Trainers’ Society
Congress of Neurological Surgeons
National Athletic Trainers’
Association
NCAA Concussion Task Force
Sports Neuropsychological Society
American Football Coaches
Association
Football Championship Subdivision
Executive Committee
National Association of Collegiate
Directors of Athletics
National Football Foundation
MENTAL HEALTH
CARDIAC HEALTH
CARDIAC TASK FORCE
Inter-Association Consensus Recommendations
for the Cardiac Care of College Student-Athletes
•
•
•
•
•
•
•
•
•
Introduction.
Cardiovascular Risk in Student-Athletes.
The Pre-Participation Evaluation.
Evidence Supporting the Use of the Pre-Participation Evaluation for
Detection of Cardiovascular Disease.
The Feasibility and Scientific Validity of Utilizing the
Electrocardiogram as a Screening Tool for the Prevention of Sudden
Cardiac Death.
Treatment of Cardiac Arrest.
Cardiac Research Initiatives.
Inter-Association Recommendations.
Checklist.
OVERUSE & EARLY SPECIALIZATION
SOCCER SUMMIT
www.ncaa.org/soccerhealth
WRESTLING SUMMIT
Sport-Specific Summits
•
•
•
•
•
•
•
•
USOC, NGBs, NCAA and invited scientists.
Early Specialization.
Overuse Injuries.
Illnesses.
Periodization.
Concussion Risk.
Rules Implications.
Wellness for Life.
DOPING & RECREATIONAL DRUG USE
Doping and Recreational Drug Use
Doping is cheating.
Recreational drug use is different.
Inconsistency is problematic.
Need: Effective deterrence model.
Need: Conference consistency.
Need: Effective intervention.
Injury surveillance
DATA ANALYTICS & INFORMATICS
Data Analytics
Evidence-based decisions.
No centralized data collection or analysis.
Solution: Datalys.
Solution: Trust.
Target: PPE.
Thank you.