Comparison of reporting systems to determine concussion incidence in NCAA Division I collegiate football

Objective: To determine the incidence of concussion during the 2001 Division I-A college football season through utilization of the Internet. Design: Prospective Internet survey. Setting: Internet Web site. Participants: Head athletic trainers from Division I-A collegiate football programs. Main Outcome Measures: During the 2001-2002 football season, head athletic trainers from 87 Division I-A football programs agreed to use an Internet Web site to submit weekly data on the number of athlete exposures and concussions. Results: A total of 373 concussions were reported over the course of a season in both practices and games combined. Of these concussions, 256 (68.6%) occurred during games, and 117 (31.4%) occurred during practice. The injury rate per 1,000 athletic exposures was 5.56 in games and 0.25 in practices. There were 230 grade 1 (61.7%), 134 grade 2 (35.9%), and 9 grade 3 (2.4%) concussions reported. There was a significant (p < 0.01) difference found between the total concussion injury rate and game concussion injury rate when comparing the Internet and the NCAA injury data collection methods. Conclusions: The results of this study suggest an underreporting of concussions using the NCAA Injury Surveillance System and demonstrate that the Internet is a simple and effective tool for data collection.