Severely Flawed NFL Concussion Research, Ties To Big Tobacco

The National Football League is facing serious questions about it’s concussion research.

Severely Flawed NFL Concussion Research, Ties To Big Tobacco

Following the early retirement of several of its marquee players due to a long string of frightening concussions, the league created a committee in 1994 that would ultimately issue a succession of research papers that downplayed the danger of head injuries in the sport. Experts and physicians were eventually brought amidst criticism of the committee’s work, and these physicians concluded that the papers had relied on faulty analysis.

Now, an investigation by the New York Times has discovered that the NFL’s concussion research was even more flawed than it had been previously found.

The NFL has stood by its research for 13 years, claiming it is based on full accounting of all concussions diagnosed by team physicians from 1996 through 2001. However, confidential data obtained by The Times shows that over 100 diagnosed concussions were omitted from these studies–including some severe injuries to stars like quarterbacks Steve Young and Troy Aikman.

After The Times asked the league about the missing diagnosed cases — which represented more than 10 percent of the total — officials acknowledged that “the clubs were not required to submit their data and not every club did.” That should have been made clearer, the league said in a statement, adding that the missing cases were not part of an attempt “to alter or suppress the rate of concussions.”

There also seems to be some lack of transparency even within the committee. One member of the concussion committee, Dr. Joseph Waeckerle, said he was unaware of the omissions. But he added: “If somebody made a human error or somebody assumed the data was absolutely correct and didn’t question it, well, we screwed up. If we found it wasn’t accurate and still used it, that’s not a screw-up; that’s a lie.”

These new discoveries raise further questions regarding the authenticity of the committee’s findings, published in 123 peer-reviewed articles and presented by the league as scientific evidence that brain injuries from repeated blows to the head did not cause long-term harm to its players like the degenerative brain disease known as Chronic Traumatic Encephalopathy, or CTE. Even stranger is the fact that the omissions went unchallenged by league officials, by the epidemiologist tasked with collecting the data, and by the editor of the medical journal who published the studies.

In 2013, the N.F.L. agreed to a $765 million settlement of a lawsuit in which retired players accused league officials of covering up the risks of concussions. Some players have appealed this settlement, demanding a full, proper examination of the committee’s concussion research.

Some retired NFL players have also compared the the league’s managing of this health issue to that of the tobacco industry, which became notorious for using questionable science to downplay the dangers of smoking cigarettes.

The Times has so far found no direct evidence that the NFL took its strategy from the tobacco industry.

In a letter to The Times, a lawyer for the league stated, “The N.F.L. is not the tobacco industry; it had no connection to the tobacco industry,” which he called “perhaps the most odious industry in American history.”

However, records indicate that the two industries shared lobbyists, lawyers, and consultants.

The N.F.L.’s concussion committee began publishing its findings in 2003 in the medical journal Neurosurgery.

It wasn’t up until very recently that the league’s research was found to be this severely inaccurate. Very few, even the NFL’s harshest critics, suggested or proved that the underlying data set was so faulty.

“One of the rules of science is that you need to have impeccable data collection procedures,” said Bill Barr, a neuropsychologist who once worked for the New York Jets and who has previously criticized the committee’s work.

By excluding so many concussions, Mr. Barr said, “You’re not doing science here; you are putting forth some idea that you already have.”

The committee’s chairman, Dr. Elliot Pellman, the team physician for the Jets, stressed that his group’s primary objective was to produce research that was “independent” and “meticulous.”

Although many of the dozen committee members were associated with NFL Teams, either as a physician, a neurosurgeon, or an athletic trainer, the members stated that these relationships had not compromised their work as researchers.

“It was understood that any player with a recognized symptom of head injury, no matter how minor, should be included in the study,” one paper said.

And in confidential peer-review documents, the committee wrote that “all N.F.L. teams participated” and that “a ll players were therefore part of this study.”

However, those statements are contradicted by the database.

According to the Times, most teams failed to report all of their players’ concussions. Overall, at least 10 percent of head injuries diagnosed by team doctors were missing from the study, including two that were sustained by Jets receiver Wayne Chrebet, who retired several years later following more concussions. Dr. Pellman, the Jets’ physician, led the research and was the lead author on every paper.

In one paper, the committee explained, “The Commissioner of the N.F.L. mandated all team physicians to complete and return forms whenever they examined a player with a head injury.”

Teams were not obligated to participate, but rather only “strongly encouraged.” An NFL spokesman later added that some teams “did not take the additional steps of supplying the initial and/or follow-up forms.”

The NFL also explained that some concussions went undiagnosed because players sometimes hid their symptoms of concussion from team doctors, symptoms that can often be so brief no one even notices. Thus, doctors may have used a different set of criteria to make concussion diagnoses.

Nevertheless, most of omitted concussions identified by The Times were included in the N.F.L.’s public injury reports, which means that medical staffs had made the diagnoses and reported them to the league.

The database does not include any concussions involving the Dallas Cowboys for all six seasons, including four to Mr. Aikman that were listed on the N.F.L.’s official midweek injury reports or were widely reported in the news media.

Furthermore, some injuries were more severe than what was reflected in the official tally. According to committee records, St. Louis Rams quarterback Kurt Warner sustained a concussion on Dec. 24, 2000, that healed after two days. But Mr. Warner’s symptoms continued, and four weeks later he was ruled out of the Pro Bowl with what a league official described as lingering symptoms of that head injury.

The NFL refused to make Dr. Pellman available for an interview. John Powell and Michael L.J. Apuzzo, the study’s epidemiologist and the editor of Neurosurgery respectively, also declined interview requests.

Caption: DENVER, CO – SEPTEMBER 14: The NFL logo is displayed on the turf as the Denver Broncos defeated the Kansas City Chiefs 24-17 at Sports Authority Field at Mile High on September 14, 2014 in Denver, Colorado. (Photo by Doug Pensinger/Getty Images).