thank you very much I’m very happy to be here this morning and to talk to you
here this morning and to talk to you
here this morning and to talk to you about concussions which is something
about concussions which is something
about concussions which is something that we’ve all heard a lot about so
that we’ve all heard a lot about so
that we’ve all heard a lot about so there’s a saying that goes if you’ve
there’s a saying that goes if you’ve
there’s a saying that goes if you’ve seen one concussion you’ve seen one
seen one concussion you’ve seen one
seen one concussion you’ve seen one concussion well the first time I heard
concussion well the first time I heard
concussion well the first time I heard that I had to say it to myself again so
that I had to say it to myself again so
that I had to say it to myself again so I’ll say it to you again if I’ve seen
I’ll say it to you again if I’ve seen
I’ll say it to you again if I’ve seen one concussion I’ve seen one concussion
one concussion I’ve seen one concussion
one concussion I’ve seen one concussion well taken literally that means that
well taken literally that means that
well taken literally that means that every single concussion is different so
every single concussion is different so
every single concussion is different so as a researcher we’ve really known that
as a researcher we’ve really known that
as a researcher we’ve really known that for years actually doctors know that
for years actually doctors know that
for years actually doctors know that parents know that so so what’s the big
parents know that so so what’s the big
parents know that so so what’s the big problem so where are we why is
problem so where are we why is
problem so where are we why is concussion so confusing well part of the
concussion so confusing well part of the
concussion so confusing well part of the reason is is because our brains are all
reason is is because our brains are all
reason is is because our brains are all different they’re not all the same and
different they’re not all the same and
different they’re not all the same and every concussion is different – you can
every concussion is different – you can
every concussion is different – you can get a concussion in a car accident
get a concussion in a car accident
get a concussion in a car accident playing sports even falling down at home
playing sports even falling down at home
playing sports even falling down at home every single brain is different so what
every single brain is different so what
every single brain is different so what exactly is a concussion and why don’t we
exactly is a concussion and why don’t we
exactly is a concussion and why don’t we know more about it well a concussion is
know more about it well a concussion is
know more about it well a concussion is a mild brain injury so it is a brain
a mild brain injury so it is a brain
a mild brain injury so it is a brain injury results from an impact to the
injury results from an impact to the
injury results from an impact to the head so anything that you can impact
head so anything that you can impact
head so anything that you can impact your head results in neurological
your head results in neurological
your head results in neurological symptoms memory problems confusion
symptoms memory problems confusion
symptoms memory problems confusion balance problems forgetfulness so we’ve
balance problems forgetfulness so we’ve
balance problems forgetfulness so we’ve known about the relationship between
known about the relationship between
known about the relationship between getting your head hit and neurological
getting your head hit and neurological
getting your head hit and neurological function for some time or over a century
function for some time or over a century
function for some time or over a century we’ve known this ever since we started
we’ve known this ever since we started
we’ve known this ever since we started ramming our heads together on purpose so
ramming our heads together on purpose so
ramming our heads together on purpose so the first football game the for college
the first football game the for college
the first football game the for college football game was in the late 19th
football game was in the late 19th
football game was in the late 19th century I think everybody knows back
century I think everybody knows back
century I think everybody knows back then there were leather helmets and this
then there were leather helmets and this
then there were leather helmets and this wasn’t such a good idea as we know now
wasn’t such a good idea as we know now
wasn’t such a good idea as we know now but they didn’t know that so there was
but they didn’t know that so there was
but they didn’t know that so there was many deaths some serious injuries then
many deaths some serious injuries then
many deaths some serious injuries then eventually that led to the use of hard
eventually that led to the use of hard
eventually that led to the use of hard helmet
helmet
helmet and different rules as we all know today
and different rules as we all know today
and different rules as we all know today around the same time in the early 20th
around the same time in the early 20th
around the same time in the early 20th century boxing became more and more
century boxing became more and more
century boxing became more and more popular it was as popular then as
popular it was as popular then as
popular it was as popular then as football is today
football is today
football is today soon medical reports started to emerge
soon medical reports started to emerge
soon medical reports started to emerge though that showed a relationship
though that showed a relationship
though that showed a relationship between the impact to the head and brain
between the impact to the head and brain
between the impact to the head and brain damage and then we all have heard about
damage and then we all have heard about
damage and then we all have heard about traumatic brain injury and war
traumatic brain injury and war
traumatic brain injury and war well traumatic brain injury has been a
well traumatic brain injury has been a
well traumatic brain injury has been a war wound for many many years many
war wound for many many years many
war wound for many many years many centuries in the last conflict traumatic
centuries in the last conflict traumatic
centuries in the last conflict traumatic brain injury was known as the signature
brain injury was known as the signature
brain injury was known as the signature wound of the war but perhaps the most
wound of the war but perhaps the most
wound of the war but perhaps the most the most telling and the biggest
the most telling and the biggest
the most telling and the biggest shake-up to the community has been the
shake-up to the community has been the
shake-up to the community has been the finding of degeneration in professional
finding of degeneration in professional
finding of degeneration in professional football players brains it’s been 15
football players brains it’s been 15
football players brains it’s been 15 years since we first saw this and we’ve
years since we first saw this and we’ve
years since we first saw this and we’ve seen player after player we’ve seen this
seen player after player we’ve seen this
seen player after player we’ve seen this discovered in their brain so so now
discovered in their brain so so now
discovered in their brain so so now there’s a lot of talk about concussion
there’s a lot of talk about concussion
there’s a lot of talk about concussion you hear it in the media you hear it all
you hear it in the media you hear it all
you hear it in the media you hear it all the time so what’s going on you know we
the time so what’s going on you know we
the time so what’s going on you know we hear about concussion protocols what’s a
hear about concussion protocols what’s a
hear about concussion protocols what’s a concussion protocol does my kid really
concussion protocol does my kid really
concussion protocol does my kid really need to be doing that tackling technique
need to be doing that tackling technique
need to be doing that tackling technique or that tackling technique are we gonna
or that tackling technique are we gonna
or that tackling technique are we gonna get rid of football well I’m not sure
get rid of football well I’m not sure
get rid of football well I’m not sure that that’s the way that that’s why it’s
that that’s the way that that’s why it’s
that that’s the way that that’s why it’s gonna go but what are we doing what are
gonna go but what are we doing what are
gonna go but what are we doing what are we doing about it why aren’t we doing
we doing about it why aren’t we doing
we doing about it why aren’t we doing better are we doing any better than we
better are we doing any better than we
better are we doing any better than we were 10 15 20 years ago some might say
were 10 15 20 years ago some might say
were 10 15 20 years ago some might say yes we no longer say oh he got his bell
yes we no longer say oh he got his bell
yes we no longer say oh he got his bell rung or how many fingers am i holding up
rung or how many fingers am i holding up
rung or how many fingers am i holding up but I’m here to tell you that no I don’t
but I’m here to tell you that no I don’t
but I’m here to tell you that no I don’t think we’re doing that much better than
think we’re doing that much better than
think we’re doing that much better than we were 20 years ago so what’s the big
we were 20 years ago so what’s the big
we were 20 years ago so what’s the big deal why is it so difficult to detect
deal why is it so difficult to detect
deal why is it so difficult to detect this mild brain injury sports announcers
this mild brain injury sports announcers
this mild brain injury sports announcers do it all the time well sometimes it’s
do it all the time well sometimes it’s
do it all the time well sometimes it’s obvious then someone’s had a brain
obvious then someone’s had a brain
obvious then someone’s had a brain injury and sometimes it’s not so obvious
injury and sometimes it’s not so obvious
injury and sometimes it’s not so obvious what we want to know are the ones that
what we want to know are the ones that
what we want to know are the ones that aren’t so obvious so and even when it’s
aren’t so obvious so and even when it’s
aren’t so obvious so and even when it’s obvious sometimes it can still be messy
obvious sometimes it can still be messy
obvious sometimes it can still be messy dehydration for example that can mimic
dehydration for example that can mimic
dehydration for example that can mimic the signs of a concussion can lead to
the signs of a concussion can lead to
the signs of a concussion can lead to inbound
inbound
inbound problems and this and that so what is
problems and this and that so what is
problems and this and that so what is this why I call this a signal-to-noise
this why I call this a signal-to-noise
this why I call this a signal-to-noise problem okay we have the big signal the
problem okay we have the big signal the
problem okay we have the big signal the real signals concussion and then we have
real signals concussion and then we have
real signals concussion and then we have the noise we have all the other noise
the noise we have all the other noise
the noise we have all the other noise like dehydration so when you have a
like dehydration so when you have a
like dehydration so when you have a really large signal like you would for
really large signal like you would for
really large signal like you would for loss of consciousness everybody knows
loss of consciousness everybody knows
loss of consciousness everybody knows that if you see a football player laying
that if you see a football player laying
that if you see a football player laying down during game or soccer player they
down during game or soccer player they
down during game or soccer player they probably have a concussion so there the
probably have a concussion so there the
probably have a concussion so there the signal you can see it among the noise
signal you can see it among the noise
signal you can see it among the noise but most of the time to have small
but most of the time to have small
but most of the time to have small signals and a lot of noise dehydration
signals and a lot of noise dehydration
signals and a lot of noise dehydration different medical conditions different
different medical conditions different
different medical conditions different medications and this is where the
medications and this is where the
medications and this is where the confusion comes in so it’s confusing and
confusion comes in so it’s confusing and
confusion comes in so it’s confusing and now it’s also very messy okay so what
now it’s also very messy okay so what
now it’s also very messy okay so what I’m here to talk to you today about is
I’m here to talk to you today about is
I’m here to talk to you today about is to try to convince you that we can use
to try to convince you that we can use
to try to convince you that we can use data science to clear up this messiness
data science to clear up this messiness
data science to clear up this messiness to clear up this confusion and move
to clear up this confusion and move
to clear up this confusion and move forward so what if we were able to say
forward so what if we were able to say
forward so what if we were able to say that you have a brain fingerprint
that you have a brain fingerprint
that you have a brain fingerprint everybody in this room and everybody
everybody in this room and everybody
everybody in this room and everybody watching they have unique features about
watching they have unique features about
watching they have unique features about their brain so if they have a particular
their brain so if they have a particular
their brain so if they have a particular situation that they think is a
situation that they think is a
situation that they think is a concussion we know what their
concussion we know what their
concussion we know what their fingerprint looks like and we know how
fingerprint looks like and we know how
fingerprint looks like and we know how bad their concussion is what if I could
bad their concussion is what if I could
bad their concussion is what if I could say your concussion scores a 9.2 you’ve
say your concussion scores a 9.2 you’ve
say your concussion scores a 9.2 you’ve had a mild traumatic brain injury you’ve
had a mild traumatic brain injury you’ve
had a mild traumatic brain injury you’ve suffered a contusion to your frontal
suffered a contusion to your frontal
suffered a contusion to your frontal brain that’s causing your memory
brain that’s causing your memory
brain that’s causing your memory problems but the good news is that your
problems but the good news is that your
problems but the good news is that your blood work and your imaging work and all
blood work and your imaging work and all
blood work and your imaging work and all of your other signs they tell us that
of your other signs they tell us that
of your other signs they tell us that you need to rest for a few days you need
you need to rest for a few days you need
you need to rest for a few days you need to avoid any heavy extraneous activity
to avoid any heavy extraneous activity
to avoid any heavy extraneous activity for two weeks and if you get at least
for two weeks and if you get at least
for two weeks and if you get at least eight hours of sleep a night
eight hours of sleep a night
eight hours of sleep a night like any of us get that anymore you have
like any of us get that anymore you have
like any of us get that anymore you have a 98% chance of a full recovery or you
a 98% chance of a full recovery or you
a 98% chance of a full recovery or you have a concussion score of 7.1 you’ve
have a concussion score of 7.1 you’ve
have a concussion score of 7.1 you’ve suffered a mild brain injury to your
suffered a mild brain injury to your
suffered a mild brain injury to your parietal cortex that’s causing you all
parietal cortex that’s causing you all
parietal cortex that’s causing you all these problems that you’re having today
these problems that you’re having today
these problems that you’re having today but as of your medical history of
but as of your medical history of
but as of your medical history of frequent migraines your three previous
frequent migraines your three previous
frequent migraines your three previous concussion
concussion
concussion and all of your tests your balance
and all of your tests your balance
and all of your tests your balance problems our most art you’re gonna have
problems our most art you’re gonna have
problems our most art you’re gonna have a 20% chance of continuing those balance
a 20% chance of continuing those balance
a 20% chance of continuing those balance problems and developed dizzy problems
problems and developed dizzy problems
problems and developed dizzy problems and you have to have a now your risk for
and you have to have a now your risk for
and you have to have a now your risk for chronic traumatic encephalopathy or CTE
chronic traumatic encephalopathy or CTE
chronic traumatic encephalopathy or CTE degeneration of the brain that’s gone up
degeneration of the brain that’s gone up
degeneration of the brain that’s gone up from five to ten percent so I’m here to
from five to ten percent so I’m here to
from five to ten percent so I’m here to tell you that this is possible it’s
tell you that this is possible it’s
tell you that this is possible it’s possible for each of us to have our own
possible for each of us to have our own
possible for each of us to have our own profile in the unlikely event that we
profile in the unlikely event that we
profile in the unlikely event that we hit our heads and have a concussion so
hit our heads and have a concussion so
hit our heads and have a concussion so how are we going to do this how is it
how are we going to do this how is it
how are we going to do this how is it that we can we can have a personalized
that we can we can have a personalized
that we can we can have a personalized diagnosis well I think everybody in this
diagnosis well I think everybody in this
diagnosis well I think everybody in this room has probably heard of personalized
room has probably heard of personalized
room has probably heard of personalized medicine there’s a lot of research into
medicine there’s a lot of research into
medicine there’s a lot of research into cancer treatments tailoring cancer
cancer treatments tailoring cancer
cancer treatments tailoring cancer treatments and doing genetic genomic
treatments and doing genetic genomic
treatments and doing genetic genomic sequencing to see what your genetic
sequencing to see what your genetic
sequencing to see what your genetic risks are for a certain disease but in
risks are for a certain disease but in
risks are for a certain disease but in the world of concussion there’s a lot of
the world of concussion there’s a lot of
the world of concussion there’s a lot of research there’s a lot of confounding
research there’s a lot of confounding
research there’s a lot of confounding research there’s a lot of conflicting
research there’s a lot of conflicting
research there’s a lot of conflicting research and we’ve been very slow to
research and we’ve been very slow to
research and we’ve been very slow to adopt this concept in concussion
adopt this concept in concussion
adopt this concept in concussion medicine there’s international
medicine there’s international
medicine there’s international guidelines that have been put out by
guidelines that have been put out by
guidelines that have been put out by experts yet less than 10% of US
experts yet less than 10% of US
experts yet less than 10% of US physicians are using those guidelines so
physicians are using those guidelines so
physicians are using those guidelines so they’re taking lots of data points are
they’re taking lots of data points are
they’re taking lots of data points are taking lots of information but it’s
taking lots of information but it’s
taking lots of information but it’s still very messy we still don’t know
still very messy we still don’t know
still very messy we still don’t know what to do with all this all this
what to do with all this all this
what to do with all this all this messiness so typically concussion
messiness so typically concussion
messiness so typically concussion diagnoses are based on just a few data
diagnoses are based on just a few data
diagnoses are based on just a few data points a few symptoms a clinical exam
points a few symptoms a clinical exam
points a few symptoms a clinical exam your doctors experience of course but
your doctors experience of course but
your doctors experience of course but there’s still just a few data points so
there’s still just a few data points so
there’s still just a few data points so for example if you had a small hit to
for example if you had a small hit to
for example if you had a small hit to the head that means that that’s a low
the head that means that that’s a low
the head that means that that’s a low risk and you have a low chance of having
risk and you have a low chance of having
risk and you have a low chance of having a concussion obviously if you have a
a concussion obviously if you have a
a concussion obviously if you have a higher hit a larger hit you have a
higher hit a larger hit you have a
higher hit a larger hit you have a higher risk and a higher chance of gain
higher risk and a higher chance of gain
higher risk and a higher chance of gain concussion well each clinical symptom
concussion well each clinical symptom
concussion well each clinical symptom each clinical test that they do is going
each clinical test that they do is going
each clinical test that they do is going to tell the doctor something about your
to tell the doctor something about your
to tell the doctor something about your risk
risk
risk and your chances for suffering a brain
and your chances for suffering a brain
and your chances for suffering a brain injury or what your outcome is going to
injury or what your outcome is going to
injury or what your outcome is going to be okay but in reality we eat each and
be okay but in reality we eat each and
be okay but in reality we eat each and every one of us has dozens and even
every one of us has dozens and even
every one of us has dozens and even hundreds of signals we have a brain
hundreds of signals we have a brain
hundreds of signals we have a brain fingerprint okay so we need to be taking
fingerprint okay so we need to be taking
fingerprint okay so we need to be taking all of these factors we need to know how
all of these factors we need to know how
all of these factors we need to know how hard to hit was how many kids you’ve had
hard to hit was how many kids you’ve had
hard to hit was how many kids you’ve had in the past maybe this was just a
in the past maybe this was just a
in the past maybe this was just a one-time hit you’re not an athlete we
one-time hit you’re not an athlete we
one-time hit you’re not an athlete we need to know what medications you’re on
need to know what medications you’re on
need to know what medications you’re on what your medical history is what your
what your medical history is what your
what your medical history is what your diet is and so on so we can take all of
diet is and so on so we can take all of
diet is and so on so we can take all of these data points and we can use
these data points and we can use
these data points and we can use algorithms to create personalized
algorithms to create personalized
algorithms to create personalized fingerprints that can allow us to have
fingerprints that can allow us to have
fingerprints that can allow us to have diagnoses and treatment plans that are
diagnoses and treatment plans that are
diagnoses and treatment plans that are just for you and your brain so this is a
just for you and your brain so this is a
just for you and your brain so this is a data-driven approach we call this and
data-driven approach we call this and
data-driven approach we call this and what we can do this is we can have
what we can do this is we can have
what we can do this is we can have individual plans for everybody so say a
individual plans for everybody so say a
individual plans for everybody so say a fourteen-year-old has a hit in a
fourteen-year-old has a hit in a
fourteen-year-old has a hit in a football game so based on his symptoms
football game so based on his symptoms
football game so based on his symptoms he has a certain type of concussion a
he has a certain type of concussion a
he has a certain type of concussion a woman Falls from her bike hits her head
woman Falls from her bike hits her head
woman Falls from her bike hits her head she has another set of history facts and
she has another set of history facts and
she has another set of history facts and conditions and symptoms this is a
conditions and symptoms this is a
conditions and symptoms this is a different subtype of injury and then we
different subtype of injury and then we
different subtype of injury and then we have a man who plays soccer on the
have a man who plays soccer on the
have a man who plays soccer on the weekends in an adult league you really
weekends in an adult league you really
weekends in an adult league you really can’t remember if he had any concussions
can’t remember if he had any concussions
can’t remember if he had any concussions as a kid but he has migraines and his
as a kid but he has migraines and his
as a kid but he has migraines and his migraines get worse when he plays soccer
migraines get worse when he plays soccer
migraines get worse when he plays soccer but he doesn’t have a concussion
but he doesn’t have a concussion
but he doesn’t have a concussion based on his tests so how how do we get
based on his tests so how how do we get
based on his tests so how how do we get there
there
there how do we get to this point well we need
how do we get to this point well we need
how do we get to this point well we need to demand personalized health for our
to demand personalized health for our
to demand personalized health for our brains we need to demand this like we
brains we need to demand this like we
brains we need to demand this like we would for chemotherapy like we would for
would for chemotherapy like we would for
would for chemotherapy like we would for genetic risks we need to participate in
genetic risks we need to participate in
genetic risks we need to participate in research there’s a lot of research we
research there’s a lot of research we
research there’s a lot of research we need to do we need to support
need to do we need to support
need to do we need to support crowdsourcing our data because we need
crowdsourcing our data because we need
crowdsourcing our data because we need all those data points to create these
all those data points to create these
all those data points to create these algorithms we need to insist on
algorithms we need to insist on
algorithms we need to insist on concussion education
concussion education
concussion education we need to ask our doctors about the
we need to ask our doctors about the
we need to ask our doctors about the latest concussion guidelines okay we’re
latest concussion guidelines okay we’re
latest concussion guidelines okay we’re not in the darkroom anymore okay what
not in the darkroom anymore okay what
not in the darkroom anymore okay what are the latest guidelines insist that
are the latest guidelines insist that
are the latest guidelines insist that they keep up with that we need to insist
they keep up with that we need to insist
they keep up with that we need to insist that our schools all of our schools have
that our schools all of our schools have
that our schools all of our schools have athletic trainers and school nurses but
athletic trainers and school nurses but
athletic trainers and school nurses but we need to participate in sports we need
we need to participate in sports we need
we need to participate in sports we need to know our risks because data is power
to know our risks because data is power
to know our risks because data is power and the more data you have and the more
and the more data you have and the more
and the more data you have and the more you know the more that you can make
you know the more that you can make
you know the more that you can make decisions so together we can get from
decisions so together we can get from
decisions so together we can get from having very messy messy diagnosis even
having very messy messy diagnosis even
having very messy messy diagnosis even this diagnosis we don’t want to have Mis
this diagnosis we don’t want to have Mis
this diagnosis we don’t want to have Mis diagnosis we want to get it right okay
diagnosis we want to get it right okay
diagnosis we want to get it right okay so we have all this noise we have a lot
so we have all this noise we have a lot
so we have all this noise we have a lot of misdiagnosis
of misdiagnosis
of misdiagnosis but together by using these data science
but together by using these data science
but together by using these data science techniques and by demanding that we have
techniques and by demanding that we have
techniques and by demanding that we have this type of education for our doctors
this type of education for our doctors
this type of education for our doctors in our schools together we can come up
in our schools together we can come up
in our schools together we can come up with precision medicine for our brains
with precision medicine for our brains
with precision medicine for our brains and avoid the concussion confusion thank
and avoid the concussion confusion thank
and avoid the concussion confusion thank you
”
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