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Julian A. Owen, Matthew B. Fortes, Saeed Ur Rahman, Mahdi Jibani, Neil P. Walsh and Samuel J. Oliver

has investigated the validity and diagnostic accuracy of these hydration markers to identify more mild ED or ID (≤2% of body mass). Mild dehydration is important to identify, as it is beyond this threshold that human performance has been consistently shown to decline ( Cheuvront & Kenefick, 2014

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Krista M. Hixson, Hannah B. Horris, Tamara C. Valovich McLeod and Cailee E. Welch Bacon

Clinical Scenario:

Thoracic outlet syndrome is quite challenging to diagnose. Currently, there are myriad diagnostic procedures used in the diagnosis of all types of thoracic outlet syndrome. However, controversy exists over which diagnostic procedures produce accurate findings.

Clinical Question:

Can clinical diagnostic tests accurately diagnose patients presenting with symptoms of thoracic outlet syndrome?

Summary of Key Findings:

A thorough literature search returned 6 possible studies; 3 studies met the inclusion criteria and were included. Two studies supported the use of clinical diagnostic tests for the diagnosis of thoracic outlet syndrome. One study reported high false-positive rates among clinical diagnostic tests for thoracic outlet syndrome. One study reported that clinical diagnostic test findings correlate to provocative positioned magnetic resonance imaging findings.

Clinical Bottom Line:

There is moderate evidence to support the use of the Halstead maneuver (also known as the costoclavicular maneuver or exaggerated military brace test), Wright’s test, Cyriax Release test, and supraclavicular pressure test to have good diagnostic accuracy for the provocation of symptoms in patients presenting with upper extremity pathology. However, these clinical diagnostic tests do not appear to allow for the differential diagnosis of thoracic outlet syndrome exclusively. The use of the Adson’s test and Roos test should be discontinued for the differential diagnosis of thoracic outlet syndrome.

Strength of Recommendation:

Grade B evidence exists to support the accuracy of the Halstead maneuver, Wright’s test, Cyriax Release test, and supraclavicular pressure test for the diagnosis of upper extremity pathology in general. Grade C evidence exists for the use of these clinical diagnostic tests to exclusively diagnose thoracic outlet syndrome.

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Rafael Squillantini, Brielle Ringle and Julie Cavallario

following search terms were used: • P atient/Client group: ACL, ACL tears, ACL sprain or anterior cruciate ligament • I ntervention: lever sign test, Lelli test • C omparison: Lachman test • O utcome: Diagnostic accuracy (using specificity [ability of test to correctly identify those with the condition] and

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Michelle A. Sandrey

results are related to the amount of perceived pain and disability. 12 Further, limited studies are available that evaluate the diagnostic accuracy 9 , 14 or reliability 1 , 11 , 12 of these tests in an athletic population. Thus, the athletic training clinician is left questioning the clinical

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Alyssa J. Wagner, Casey D. Erickson, Dayna K. Tierney, Megan N. Houston and Cailee E. Welch Bacon

Clinical Scenario:

Eating disorders in female athletes are a commonly underdiagnosed condition. Better screening tools for eating disorders in athletic females could help increase diagnosis and help athletes get the treatment they need.

Focused Clinical Question:

Should screening tools be used to detect eating disorders in female athletes?

Summary of Key Findings:

The literature was searched for studies that included information regarding the sensitivity and specificity of screening tools for eating disorders in female athletes. The search returned 5 possible articles related to the clinical question; 3 studies met the inclusion criteria (2 cross-sectional studies, 1 cohort study) and were included. All 3 studies reported sensitivity and specificity for the Athletic Milieu Direct Questionnaire version 2, the Brief Eating Disorder in Athletes Questionnaire version 2, and the Physiologic Screening Test to Detect Eating Disorders Among Female Athletes. All 3 studies found that the respective screening tool was able to accurately identify female athletes with eating disorders; however, the screening tools varied in sensitivity and specificity values.

Clinical Bottom Line:

There is strong evidence to support the use of screening tools to detect eating disorders in female athletes. Screening tools with higher sensitivity and specificity have demonstrated a successful outcome of determining athletes with eating disorders or at risk for developing an eating disorder.

Strength of Recommendation:

There is grade A evidence available to demonstrate that screening tools accurately detect female athletes at risk for eating disorders.

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Johanna M. Hoch, Cori W. Sinnott, Kendall P. Robinson, William O. Perkins and Jonathan W. Hartman

function and structure, and activity levels. 3 While there are a plethora of outcomes available for clinicians to use when treating post-ACLR patients, the literature is lacking in the diagnostic accuracy and cut-off scores of commonly used measures. The identification of cut-off scores could help better

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Megan P. Brady and Windee Weiss

Clinical Scenario A common injury among elite, recreational, and youth athletes is the anterior cruciate ligament (ACL) tear. 1 Approximately 200,000 ACL injuries occur every year. 2 The gold standard in ACL injury evaluation is diagnostic arthroscopy 3 , 4 ; however, the diagnostic accuracy of

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Damir Zubac, Drazen Cular and Uros Marusic

, several other important factors may interfere with the diagnostic accuracy of U SG . Factors such as increased muscle mass, 15 urine metabolite clearance, 16 and high-protein diets 17 have been documented to artificially increase urine concentration, independently of actual hydration status. Indeed

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Stephen Crowcroft, Katie Slattery, Erin McCleave and Aaron J. Coutts

assessed for their model fit using generalized estimating equations (GEE) and then for their diagnostic accuracy from receiver operating characteristic curve analysis. Athlete-Monitoring Variables Subjective self-report measures recorded in this study included perceived fatigue rating (1 = much worse than

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Eric Kyle O’Neal, Samantha Louise Johnson, Brett Alan Davis, Veronika Pribyslavska and Mary Caitlin Stevenson-Wilcoxson

, diagnostic accuracy was improved in ROC curves (Figure  2 ) when only data from samples in which 3% body mass loss was incurred. Table 1 Description of Sweat and Urine Variables n Sweat loss (L) % Body mass % Sweat replaced Prerun USG USG at 12 hr 2.00–2.99% 72 1.9 ± 0.3 2.65 ± 0.26 114 ± 33 1.010 ± 0.007 1