Epidemiol Health.  2021;43(1):e2021086. 10.4178/epih.e2021086.

The BRAIN-Q, a tool for assessing self-reported sport-related concussions for epidemiological studies

  • 1Centre for Primary Care and Public Health, Queen Mary University of London, London, UK
  • 2University of Bath, Bath, UK
  • 3London School of Hygiene & Tropical Medicine, London, UK
  • 4Rugby Football Union, London, UK
  • 5University of Oxford, Oxford, UK
  • 6Institute of Occupational edicine, Edinburgh, UK
  • 7Institute of Occupational Medicine and University of Manchester, Manchester, UK
  • 8School of Public Health, Imperial College London, London, UK
  • 9Department of Sustainable Health, Campus Fryslând, University of Groningen, Leeuwarden, Netherlands


The BRAIN-Q is a tool aimed at maximising the accuracy and minimising measurement error for retrospectively assessing concussions. This paper reports the agreement of the BRAIN-Q tool when compared to extant questionnaire questions, and its reproducibility when compared with its telephonic version (tBRAIN-Q).
The BRAIN-Q entails a 3-stage process: defining a concussion, creating a visual timeline with life events, and establishing detailed characteristics for each reported concussion. It was designed to be administered in-person by trained personnel, and was used in the BRAIN study. Its performance was compared with the MSK study, which previously collected a few questions in a broader self-administered questionnaire, and with the tBRAIN-Q Recall, its telephonic version.
In total, 101 participants were included, of whom 9 were re-assessed with the tBRAIN-Q. The agreement of the BRAIN-Q with the muscle skeletal-questionnaire for rugby-related concussion was 86.7% (κ=0.6). Rugby-related concussion with loss of consciousness showed lower agreement (82.0%; κ=0.6). The comparison between the BRAIN-Q and the tBRAIN-Q showed good reproducibility.
The BRAIN-Q is a relatively easy tool to administer in face-to-face assessments, and it showed optimal reproducibility. It includes a well-established definition of concussion, and is used to collect detailed information on each concussion, allowing for a number of subgroup analyses (e.g., by severity, age, or context). The BRAIN-Q is easily adaptable to other sporting settings.


Questionnaire; Evaluation; Brain concussion; Sports medicine; Epidemiologic studies
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