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Concussion research by UNC's Matthew Gfeller TBI Research Center put under scrutiny

A group of over 100 sports injury researchers signed a letter addressed to the University on Oct. 14, denouncing a paper published by The Journal of Scientific Practice and Integrity. 

Published in June in the first issue of JoSPI, the paper accused UNC’s Matthew Gfeller Sports-Related Traumatic Brain Injury Research Center of failing to disclose the presence of ADHD and learning disorders among UNC football players. 

The paper said, according to UNC graduate students’ theses on the Gfeller Center’s research, that there was a 39 percent incidence of ADHD and learning disorders among incoming athletes at UNC from 2004 to 2012. During many of those years, the paper said the incidence of ADHD and learning disorders among UNC football players was upwards of 50 percent.

Statistician and University of Utah professor Ted Tatos co-authored the paper with Don Comrie. Tatos said he stumbled across the Gfeller Center’s concussion research studies while sifting through other documents in the Carolina Digital Repository for his own research on antitrust issues in college sports. Instead, he found the graduate students’ theses.

“That’s eyebrow-raising, to say the least,” Tatos said. “So that’s when I talked to my co-author. He actually reached out to me because he had seen some of my (Twitter) postings on this, and he said, ‘Hey, wait a second. I’m looking at concussion research studies, and this is very relevant to that because these athletes are also being used as test subjects in concussion research.”

Tatos has run a personal Twitter account under his own name for the past few years. Before that, the Duke grad posted under the pseudonym “BlueDevilicious.” He said he started the account to post screenshots of documents surrounding the UNC academic-athletic scandal. Over the past three years, his tweets have become more focused on the Gfeller Center’s concussion research.

UNC professor Peter Duquette has worked closely with the Gfeller Center and was a co-signatory on the letter addressed to UNC’s executive leaders. He said finding out about Tatos’ previous Twitter postings surrounding UNC documents raised some suspicions for him.

“I’m not familiar with any previous postings or other negative commentary from that individual in the past, but when that was brought to my attention, it, for me, certainly raised a red flag,” Duquette said.

Jason Mihalik co-directs the Gfeller Center with interim Chancellor Kevin Guskiewicz, who founded it in 2010 after a helmet-to-helmet collision resulted in the death of Matthew Gfeller, a varsity football player at RJ Reynolds High School. Mihalik said he believed Tatos’ and Comrie’s original paper to be scientifically weak, and he did not plan on paying much attention to it.

“For me, if I’m to be honest, it was an example of what I would share with my students on what a poor quality study would look like,” Mihalik said.

When the information from the paper came out as an article in early October on the subscription-based sports website, The Athletic, the paper that Mihalik called “tasteless” for “attacking” graduate students suddenly became more accessible and readable to the general public. Supplemented with a three-part video documentary, the article brought about the letter that was sent to UNC’s executive leaders.

“It is our unified position that this article made numerous baseless and unfounded criticisms against UNC faculty member Dr. Kevin Guskiewicz, the UNC Matthew Gfeller Sport-Related TBI Research Center, and the larger concussion research community that we represent. Our aim in this unsolicited communication is to provide you with a factual account that refutes claims made by The Athletic,” the letter said.

The letter does several things: It calls into question the validity of JoSPI, questions the authority of Tatos and Comrie and praises and justifies the work done by the Gfeller Center — specifically the work done by Guskiewicz.

Tatos said he has never met Guskiewicz personally, and the reason documents and research produced by the Gfeller Center and UNC graduate students were used was because they were the only documents available. 

“I think our paper raises a lot of questions about the validity of that concussion research, and I think we supported our concerns with an enormous number of cites. More importantly, this isn’t so much about Kevin Guskiewicz or the paper or anything — this is ultimately about the health and safety of not only college athletes, but other populations that rely on this research,” Tatos said.

Tatos said what he believes to be flaws in the Gfeller Center’s concussion research could have been avoided by both disclosing information about UNC football players who were diagnosed with ADHD or learning disorders and their medication statuses, and by looking more closely at what the sample meant.

“About what other population is this telling us?” Tatos said. “Can it be generalized to anyone else? And our point is that, ‘Look, it doesn’t look like any other population. At all.’”

Mihalik said information about test subjects with ADHD and learning disorders was not included in the Gfeller Center’s research because it was not relevant to the studies that Tatos and Comrie called into question. Using a sensor-tapped football helmet to demonstrate, Mihalik said the football players are tested for where, when and how they are hit, and that an ADHD or learning disorder diagnosis is irrelevant.

“It’s like saying, “You’re studying apples, why didn’t you report the oranges?” It just has nothing to do with it,” Mihalik said.

Additionally, Mihalik said that players with ADHD or learning disorders were not excluded from the study because each individual served as his own baseline. Baseline testing refers to a researcher’s way to test individuals before a study begins, as to control for any relevant and existing factors.

The article published by The Athletic implies that the Gfeller Center did not control for ADHD and learning disorders. This claim is cited by Tatos’ and Comrie’s paper.

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The Athletic’s documentary also discusses where the paper’s varying rates of incidences of ADHD and learning disorders among UNC football players came from — the highest mentioned in Tatos’ and Comrie’s paper being 61 percent. In the documentary, former UNC Athletics learning specialist Mary Willingham suggests these rates may be inflated.

Mihalik said the actual number of UNC athletes diagnosed with ADHD or learning disorders during baseline testing is closer to five or 10 percent. He said he has no reason to believe these rates would be higher in these individuals outside of the additional access to resources that comes with being a college athlete.

“In many respects, college athletes oftentimes get evaluated for things that they never did before. If you look at the rate of first-time dentist appointments for college athletes, you’ll see that they’re much higher here than they were in high school. They have access to the resources. We would be foolish and careless not to give them access to these resources,” Mihalik said. 

Tatos and Comrie have both issued original responses about the Gfeller Center’s response to their paper. Both authors defended their work vigorously and used the UNC graduate students’ theses from their original paper to attempt to discredit the Gfeller Center’s response. Mihalik said that he, Guskiewicz and everyone at the Gfeller Center will continue to defend their work. 

“I’m very loyal to our team that has grown from four — when we put Matthew’s name on the center — to 25 staff and students and postdocs, and an attack on the center is an attack on them and their reputations and all of their future careers, which I will defend very, very fiercely,” Mihalik said.

On Nov. 6, 250 college educators from across the country issued an open letter to the NCAA, published in The Chronicle of Higher Education, requesting that two decades of data on ADHD and learning disorder rates among college athletes be released. The appeal said Tatos’ and Comrie’s paper, as well as The Athletic’s article, caused its signatories to fear for the exploitation of college athletes all around the country, not just at UNC. 

One of the main creators of the appeal was UNC professor Jay Smith. Smith is the co-author of “Cheated: The UNC Scandal, the Education of Athletes, and the Future of Big-Time College Sports,” a book documenting the academic-athletic scandal that began in 2010.

He said because the Gfeller Center is regarded as one of the nation’s leading concussion research institutions, other institutions base their research on its studies. Because of this, Smith said Tatos’ and Comrie’s findings have the ability to prove the contamination of concussion research studies all over the country. 

Additionally, Smith said he expects the fallout of Tatos’ and Comrie’s findings, if they turn out to be valid, to be of an even greater magnitude than the fallout of the academic-athletic scandal because of both the seriousness of the allegations and the renown of the Gfeller Center and of Guskiewicz’ work in the concussion research field.

“If [the Gfeller Center’s] research is deficient — if it’s defective — and if anyone knowingly distorted research findings, that would be an enormous scandal. It’s hard to imagine the full ramifications of it in fact, which is why we need to proceed carefully, and there needs to be an independent review,” Smith said.

The Drake Group at the University of New Haven issued a similar appeal on Nov. 7 that called on the U.S. Department of Defense to issue a private investigation into the Gfeller Center’s concussion research. While Smith and his fellow educators are trying to mobilize faculty to call on their own athletic programs and the NCAA, The Drake Group is asking for an independent investigation.

“So the two things are complementary,” Smith said. “I think our perspective is a more long-term one. We’re thinking about how athletic departments and universities can operate in 20 or 30 years from now, and the Drake Group’s objective is an immediate one: to find out whether Guskiewicz is right, or if Tatos and Comrie are right.”