Archive for March 25th, 2011

‘ImPACT’ of Dr. Maroon’s and Colleagues’ Writings

PREVIOUSLY:

In his 2007 article in ESPN The Magazine (linked in the previous post in this series), Peter Keating wrote extensively about the start-up company ImPACT Applications, whose concussion-management software was by then being used by 30 of the 32 National Football League teams.

Two of ImPACT’s co-founders, Drs. Joseph Maroon and Mark Lovell of the University of Pittsburgh Medical Center, were members of the NFL’s Committee on Mild Traumatic Brain Injury.

Christopher Randolph, professor of neurology at Loyola University Medical Center in Chicago, and former team neuropsychologist for the Chicago Bears, told Keating, “It is a major conflict of interest, scientifically irresponsible.”

Other key points:

– Lovell and a third Pitt Med Center colleague and ImPACT stakeholder, Michael Collins, were co-authors of all 19 of the publications listed in the “Reliability and Validity” section of the ImPACT website.

– In 2005 Loyola’s Randolph published a study in Journal of Athletic Training, which found that only one peer-reviewed article involving a prospective controlled study with ImPACT had been published.

– Another then unpublished study by Stephen Broglio, professor of kinesiology at the University of Illinois at Urbana-Champaign concluded that ImPACT and two other tested computerized systems were “less than optimal.”

– Without disclosing their financial interests, Maroon and Collins published laudatory comments on a 2006 Neurosurgery article about ImPACT that was co-authored by Lovell and three other members of the NFL concussion committee.

– Lovell declined to be interviewed for ESPN’s investigative series Outside the Lines.

NEXT: Explosive rumors about how NFL players “game” the ImPACT system to hasten return to play following concussions.


Irv Muchnick

Ahoy, Congress! Google Books Objector Pam Samuelson’s Policy Agenda

Cross-posted from http://freelancerights.blogspot.com.


Pamela Samuelson and I have two things in common. And no, neither one is a MacArthur fellowship or broad expertise in the interplay of copyright and public policy — those are all Samuelson’s.

But Pam was the highest-profile objector to the Google Books settlement, which Judge Denny Chin torpedoed this week, and I lead a slate of objectors to the “Freelance” journalists’ electronic database settlement, still awaiting a ruling at the Second Circuit Court of Appeals. We also have a passing acquaintance in the small hamlet of Berkeley, California. So when the Google news hit the other day, I sent Pam a note of congratulations.

Another thing we most assuredly do not share is access to The New York Times. The Newspaper of Record has twisted itself into journalism-not knots avoiding explanation of who is the “Muchnick” of last year’s United States Supreme Court case, Reed Elsevier v. Muchnick. But Samuelson, quite appropriately, was sounded out by The Times on the Humpty Dumpty fallout of Google Books. See “Google’s Next Stop May Be in Congress,” http://www.nytimes.com/2011/03/24/business/media/24google.html?src=busln.

“The next thing to do is think about going to Congress and getting legislation that would make particularly orphan works available to the public,” Samuelson told The Times.

Yesterday I asked Pam whether the time was ripe to push Congress for a solution to more than the narrow “orphan works” problem. I pointed out that I and other objectors in the Freelance case believe that the ultimate solution is Congressionally-codified “compulsory licenses” and royalty systems, for articles as well as books (the distinctions between such categories are increasingly irrelevant in the new information culture).

“I am working on legislative alternatives to the GBS and an extended collective licensing regime is an interesting idea,” Samuelson replied (and gave me permission to post).

Irv Muchnick

‘It’s the Concussion Crisis, Stupid’ (full text from Beyond Chron)

[originally published March 21 at Beyond Chron, http://www.beyondchron.org/articles/It_s_the_Concussion_Crisis_Stupid_Fed_Probe_of_Football_Helmet_Safety_Must_Not_Scratch_the_Surface_9009.html]

 

by Irvin Muchnick

Senator Tom Udall’s proposed bill on football helmet safety, announced last week, is a step on the road to national sports concussion reform. An analogy might be the scandal over the quality of the body armor secured for our troops in Asia. Policy questions are rarely about hardware. They’re about software – the human decisions to put our military in harm’s way abroad, or to expose our youth to unacceptable risks in fun and games at home.

We seem headed for helmet hearings in Congress in some form, on either Udall’s initiative or that of Democrats at the House Commerce Committee. What’s important at this point is to make sure these C-SPAN exercises don’t just scapegoat the manufacturers, which are almost certainly producing progressively improved helmets. Nor is the villain of the piece NOCSAE – the National Operating Committee on Standards for Athletic Equipment, an overmatched trade oversight group. The root problem is that there’s no such thing as a concussion-proof football helmet.

Let’s direct the fire where it belongs: at the industry’s upper-echelon custodians in the National Football League. Uncontrolled collisions are what have driven television rights fees and merchandise through the roofs of municipal-financed stadiums, and the league has done as little about the problem as it could get away with. Meanwhile, at great public health cost, concussion syndrome permeated down through amateur sports in frightening dimensions we are just beginning to quantify.

The situation with exaggerated promotional claims of helmet companies is exactly parallel to the NFL’s slowness to reorient coaching and rules on the field once blocking and tackling were supplanted by head-hunting.

Says Sean Morley, a former wide receiver who is now on the NFL Players Association executive committee: “Generally what they’ve done is try to blame players for how violent the game has become. They had ample opportunity to look at the science and make practical changes and give coaches an opportunity to coach players, and give the players realistic expectations of how they should change the way they hit. And they didn’t.”

The league controlled much of the basic research on concussions, largely through grants to NFL-affiliated doctors at the University of Pittsburgh Medical Center, led by Dr. Joseph Maroon, who is also the “medical director” of World Wrestling Entertainment. Such phrases probably belong in quotation marks in pro football as well as pro wrestling.

The past body of commercially compromised articles on chronic traumatic encephalopathy, published over the last decade in the prestigious journal Neurosurgery, shows a pattern of obscuring the magnitude of concussion syndrome while pushing Maroon’s band-aid diagnostic software, known as ImPACT, which is now used widely in sports at all levels.

In 2006 Maroon co-authored a Neurosurgery article, based on NFL-funded research, about the new “Revolution” design of the league’s official helmet supplier, Riddell. It turns out that the sample for Riddell’s claim of a 31 percent reduction in concussion risk was a three-year survey of 2,141 high school players in western Pennsylvania. Imagine a tobacco company bragging about reduced tar and nicotine results from a cohort of emerging smokers, rather than entrenched two-pack-a-day addicts.

In January, when Udall referred the Riddell promos to the Federal Trade Commission for further investigation, Maroon neatly triangulated, insisting that the company had distorted his findings. At the top of the Congressional witness list should be both Maroon and one of the other co-authors of the Neurosurgery article, Riddell chief engineer Thad Ide.

The public also needs to hear from Riddell’s competitors. A Boston mouth-guard manufacturer, Mahercor Laboratories, claims that as many as 30 percent of football concussions are transmitted through the jaw and dental architecture. Mahercor’s product is used by the New England Patriots, whose reported concussion rate is consistently among the industry’s lowest, but the company says it can’t get a league-wide foothold despite its recent embrace by the American military.

Vincent Ferrara, the CEO of Xenith, an innovative helmet manufacturer, told me, “Xenith has welcomed the input of the federal government in this issue. We need a more level playing field for new technologies to take hold.”

Even more than a level playing field, along with lip service about increased awareness of head injuries, we need the unfiltered history of the $9-billion-a-year National Football League’s management of a generation-long phenomenon, which is responsible for a decline in gross national mental health. It’s not just the helmets. It’s the concussion crisis, stupid.

Irvin Muchnick, author of CHRIS & NANCY: The True Story of the Benoit Murder-Suicide and Pro Wrestling’s Cocktail of Death, blogs at https://wrestlingbabylon.wordpress.com and is @irvmuch on Twitter.


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