Former IRB advisor says five-minute assessment is flawed

‘This trial with teenagers, there was no evidence for it, no clinical or medical basis or rugby basis’

Acquired Brain Injury Ireland, in association with EBIS (European Brain Injury Society), are helping to tackle the concussion crisis by hosting a concussion education conference ‘Brain Injury and Sport’ to increase awareness and education of concussion to a wide audience of coaches, clinicians, players and parents. Pictured at the conference was Dr Barry O’ Driscoll, Former IRB Medical Advisor. Photograph: David Maher / Sportsfile

Acquired Brain Injury Ireland, in association with EBIS (European Brain Injury Society), are helping to tackle the concussion crisis by hosting a concussion education conference ‘Brain Injury and Sport’ to increase awareness and education of concussion to a wide audience of coaches, clinicians, players and parents. Pictured at the conference was Dr Barry O’ Driscoll, Former IRB Medical Advisor. Photograph: David Maher / Sportsfile

Sat, Dec 14, 2013, 00:57

The International Rugby Board would have walked away from yesterday’s Brain Injury and Sport conference in the Aviva Stadium feeling they had just been on the losing side of a whipping on the front pitch.

From former Scottish international Rory Lamont describing how he was knocked out cold at least 10 times in his career and suffered dozens of concussions without any medical voice informing him that there could be an issue, to Dr Barry O’Dricoll’s claim that rugby is a civil action waiting to happen, it was not a good day for the sport’s governing body.

“I resigned from the IRB and the IRFU two years ago,” said O’Driscoll. “I resigned over the five-minute assessment, and the one that really swung me was when the IRB introduced this five-minute assessment to teenagers. Quite an incredible thing to do.”

The five-minute assessment, where a player suspected of having concussion is examined off the pitch, is on trial with most countries now using it. Called the PSCA, it was introduced in an underage competition in South Africa in 2012, the Junior Rugby World Cup.

According to the Manchester-based doctor it is dangerous and an abuse of players.

“This trial with teenagers, there was no evidence for it, no clinical or medical basis or rugby basis. You can trivialise concussion . . . that someone suspected of having concussion can have it ruled out in five minutes is a frightening message,” added O’Driscoll.

‘Tremendous record’

“It’s really open to abuse and it has already been abused in rugby. This is the IRB who have a tremendous record in welfare of players and looking after them and suddenly out of the blue they do this.

“As everyone knows in the last few months half a billion pounds has been settled by the NFL and players because of all the stuff that Chris [Nowinski, Boston University School of Medicine] spoke about. It was a misrepresentation of concussion. It is exactly what the IRB have done now.

“They have misrepresented it. They came out with a statement saying the IRB based this on the best research evidence. Not true. No research evidence. Best world practice. Not true. It’s not practised by anyone else. We have had advice from the world’s leading neurologists. Where are they, what are their names and why are they not here today.

“They have misrepresented the whole thing. This trial is pure and simple a medical trial that takes place in a small laboratory underneath the stand. If you see the protocols that they have produced they contradict each other. They are conflicting. They actually guarantee a player going back with brian damage.

“This is abuse of medical principles. I’m sorry you cannot do that. This is a patient that has been told to take part in a trial that has never been done before.

“He’s going back into an arena of sheer brutality and he’s not at any risk? The lawyers are queuing up at the door.”

O’Driscoll also attacked the IRB claims that their five-minute assessment is backed up by leading world authorities. He added that one of the leading experts on the subject of concussion, Robert Cantu, does not support their concussion protocols and is a critic of them.

‘Objective statements’

“Whenever I come and talk at something like this, the next day they come out and they’re asked about Barry O’Driscoll. (They say) we do not deal with individual opinions. I make objective statements but there is one individual opinion they do listen to,” said O’Driscoll.

“Dr Robert Cantu in the Boston Research for Concussion, a world famous centre where all the basic research has been done . . . The IRB stated we are following the guidelines of Dr Robert Cantu. Four weeks later Dr Robert Cantu stated a five-minute test is flawed. It’s irresponsible. It prevents a player from getting proper medical care.”

Lamont, who attended yesterday’s conference as a speaker, not only returned to play on numerous occasions without proper medical care but also called into question the baseline tests rugby players take.

They are then measured against the baseline score if they suffer a head injury during the season so doctors can assess if their fitness to play.

Lamont confirmed widely-held suspicions that players deliberately underachieve in the tests and have low baseline scores.

“It just means they can get back to play quicker because the score they set is low,” said the fomer international. “It’s an important thing now to educate players and explain the dangers of concussion.”