Title: Why screening to predict injury does not work â€“ and probably never willâ€¦
In this keynote lecture, Roald Bahr, who is well known as the founder of the injury & illness prevention conferences, will discuss the principles of screening to predict injury risk. He will start by presenting the basic purposes of performing a Periodic Health Examination (PHE), a.k.a. Pre-Participation Examination (PPE) and Pre-Competition Medical Assessment (PCMA). He will also present the general criteria for screening, the WHO criteria, a.k.a. the Wilson-Jugner criteria, and discuss their application in a sports medicine context.
The basic misconception is that people tend to confuse a statistical association with prediction. A number of prospective cohort studies have been done and continue being done to examine candidate risk factors for injury. And there is certainly evidence identifying such risk factors, e.g. related to strength, balance, etc. However, the next question, even when a strong association has been established between a risk factor and injury risk, is whether this can be used as a predictive screening test for injury risk. Bahr will explain these concepts, using practical examples of common injury types such as ACL injuries and acute hamstring injuries, to illustrate the fundamental difference between an association and prediction. He will also use model data to show why prediction (i.e. identifying the at-risk athlete) with acceptable test properties (sensitivity and specificity, pos. and neg. predictive value) based on a screening test is unrealistic, even with extensive future research.
Bahr will conclude his lecture by describing why and how a PHE may play a significant role in injury and illness prevention, even if prediction is not possible.
Roald BAHR, MD PhD Professor
Department of Sports Medicine
PO Box 2020
Sportstown, 2020 Norway
Roald Bahr is the Professor of Sports Medicine at the Department of Sports Medicine at the Norwegian School of Sport Sciences and Chair of the Oslo Sports Trauma Research Center. He also holds a clinical appointment in the Medical Department at the National Olympic Training Center, where he has been the Chief Medical Officer and Chair of the Health Department since 2011. Prof Bahr also joined Aspetar Orthopaedic & Sports Medicine Hospital as Head of the Aspetar Sports Injury & Illness Prevention Programme in October 2012.
He is authorized as a Sports Medicine Physician by the Norwegian Society of Sports Medicine and is a fellow of the American College of Sports Medicine. He serves as Team Physician for the beach volleyball national teams. He is past chair of the National Council on Physical Activity, past president of the Norwegian Society of Sports Medicine, a current member of the Sports Medicine Council of the Norwegian Olympic Committee and Confederation of Sports. He is past president and current member of the FIVB Medical Commission and a member of the IOC Medical Commissionâ€”Medical and Scientific Group.
His main research area is prevention of injuries and other health problems in sports, and he has published more than 200 original research articles, review papers and book chapters, in addition to 10 books, with a citation index (H-index) of 53. He is the main editor of the widely acclaimed textbook â€śIOC Manual of Sports Injuriesâ€ť and the â€śHandbook of Sports Injury Preventionâ€ť, both published in several languages. In October 2008 at Buckingham Palace, Professor Bahr was presented with the Prince Philip Medal for his outstandingly significant and original contribution to the advancement of medical knowledge in Sports and Exercise Medicine by His Royal Highness The Prince Philip, The Duke of Edinburgh. In 2015, Bahr, shared with Lars Engebretsen, Jon Karlsson and Michael KjĂ¦r, was awarded the 1 mill SEK Nordic Prize in Medicine for research on sports medicine and physical activity.
Professor Bahr is also a former national team volleyball player and coach, and is married with three children.