The purpose of this study was to determine the frequency of misreporting of concussion symptoms of NCAA Division I-III student-athletes and to learn why and how they were able to falsify information on baseline or follow-up concussion testing. We gathered contact information from all NCAA Division I-III schools targeting those with contact sports. We split the United States into 7 regions and randomly selected 15 schools from each NCAA level within each region. Coaches from each school were then contacted and asked to forward the survey to the student-athletes on his/her team. Data was received from 817 athletes. The first hypothesis of this study stated that athletes have figured out ways to falsify and misreport results on a baseline and/or follow up concussion testing. Several questions in our survey asked about different ways to falsify information on concussion testing. Results included 76 out of 317 (24%) hid their concussion from medical staff, 47 out of 286 (16%) said they would hide their symptoms from staff, 47 out of 187 (25%) admitted hiding symptoms when returning to play, 34 out of 258 (13%) confessed they would alter results to return to play quicker and 37 out of 314 (12%) admitted that if they sustained another concussion they would hide their symptoms from sports medicine staff. Chi2 results did not support this hypothesis. Our second hypothesis was Division I athletes are more likely not to report concussion symptoms than Division II or III. In the survey, two questions were linked to this hypothesis: "Have you been diagnosed with a concussion?" and "Have you sustained a concussion but did not report it to anyone?" The results showed no significant differences; 83 out of 189 (44%) Division I athletes, 104 out of 305 (34%) Division II athletes and 139 out of 312 (44%) Division III athletes reported having had a diagnosed concussion. 78 out of 189 (41%) Division I athletes, 105 out of 305 (34%) Division II athletes, and 132 out of 312 (42%) Division III athletes stated they had sustained non-reported concussion during their collegiate career. Although both hypotheses were rejected, data collected from the survey showed that non-reporting and lying about concussion symptoms is occurring in the NCAA. Further studies of a larger population of NCAA athletes would help medical providers better understand ways in which concussion testing and diagnoses can be improved to protect patients.
