• Christina Mack, Rachel R Sendor, Gary Solomon, Richard G Ellenbogen, Emily Myers, Mitchel Berger, and Allen Sills.
• IQVIA, Research Triangle Park, Durham, North Carolina.
• Neurosurgery. 2020 Aug 1; 87 (2): 312-319.

BackgroundThe real-time detection of concussive injury in professional sports can be challenging for the healthcare provider on the sideline. It can be difficult to monitor all on-field players during active game play and diagnose complex injuries such as concussion during a fast-paced athletic event.ObjectiveTo enhance the in-game identification of potentially concussed professional athletes, the National Football League (NFL) initiated an Unaffiliated Neurotrauma Consultants (UNC) program in 2013, which, in tandem with other in-arena spotters and live video review systems, is designed to improve the safety of the players through enhanced concussion detection efforts.MethodsThis paper reports on the evolution of the UNC program, describes its participants and training requirements, details the role of UNC involvement, and delineates the systematic revisions and enhancements completed each year in the program.ResultsUNC reporting compliance has increased from 56% in 2014 to 100% in 2017. During the 2016 and 2017 seasons, (1) UNCs submitted an average of 1.9 evaluations per game, and (2) the UNC concussion assessments yielded sensitivity (93.4%-97.4%) and specificity (81.0%-88.3%) values.ConclusionThe UNC program has enhanced the detection of concussion in NFL players. Directions for research and future program improvements are addressed.Copyright © 2019 by the Congress of Neurological Surgeons.

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