Common ground: There needs to be a common diagnosis of concussion across all sports, Dr Martin Raftery says.

Common ground: There needs to be a common diagnosis of concussion across all sports, Dr Martin Raftery says. Photo: Getty Images

All contact sports in Australia, together with state and federal departments of health, should immediately convene to develop a common protocol for the diagnosis, treatment and prevention of concussion, Dr Martin Raftery says.

Dr Raftery, the International Rugby Board's chief medical officer, is eminently qualified to comment on concussion, being a former first grade player with Cronulla and a past club doctor for St George and the NSW Rugby League.

He has also led the IRB's campaign to prevent and manage concussion, introducing new protocols and attending international symposiums on the subject.

"I would like to call on all major sports to join forces with the appropriate government department to develop a consistent and acceptable standard that would optimise the prevention and management of concussion in sport," Dr Raftery said from Tokyo.

"Concussion is a brain injury and should be taken seriously by doctors, coaches, players, media commentators and administrators."

A national agreement by contact sports on the treatment of concussion would help reduce confusion where different approaches are taken, particularly with player substitutions, and also diffuse the debate about which sports are safer.

Shared information would also help researchers improve their diagnostic tools.

"Evidence is lacking in the area of concussion and it is accepted by the medical community and experts in this field that there is no perfect diagnostic tool or marker that a doctor can rely on to make the diagnosis," Dr Raftery said.

He is cognisant of the recent action taken in the AFL and NRL to tackle the problem, albeit late.

"Awareness and knowledge around concussion has improved dramatically over the past decade and in particular over the past three to four years, but more needs to be done," he said.

"I am aware that all sports are working to protect their athletes, and whilst different interventions are being employed, the goal is still to improve player welfare."

He said that head injuries in 2014 are being treated more conservatively than they have been in the past, even as recently as 2011.

"Prior to the IRB's rule on pitch-side intervention, 56 per cent of post-game diagnosed concussion cases returned to play," he said.

"One year after introducing temporary substitution, this figure has dropped to 13 per cent.

"Rugby is still not satisfied, so we have altered our criteria and assessment with the aim of reducing this further. There is no perfect diagnostic tool, but we are searching for it through research."

The AFL has similar figures regarding players continuing to play with concussion.

Dr Nathan Gibbs, the Swans medico and a former first grade rugby league forward with the Roosters and Rabbitohs, was quoted as saying: "Of AFL players who sustained a concussion injury, only 26 per cent were removed from the field and did not return to play in that match".

The NRL introduced its head-injury management policy this season, but it needs to be carefully monitored.

In round two, Penrith's James Segeyaro suffered a head knock but played vigorously and effectively until he was eventually replaced, raising the question whether his "free" substitution was made because he was concussed or fatiguing at the end of a close game.