Failure Mode and Effects Analysis for Chronic Traumatic Encephalopathy (CTE) in Football Players

  

Chronic Traumatic Encephalopathy (CTE)

Chronic traumatic encephalopathy (CTE) has become an emerging health issue in the National Football League (NFL). A more vital understanding of the risks associated with playing in the NFL and the connection with CTE is needed.  CTE is a progressive neurodegenerative disorder caused by repetitive traumatic brain injury (Marrero & Dlugasch, 2024). A high-impact sport with lots of collisions to the head puts NFL players at high risk for CTE.  According to Marrero and Dlugasch, 2024, every 2.6 years of professional football played doubles the odds of a player developing CTE.

A challenge with CTE is that confirmation of the disease can only be done postmortem. This challenge makes it essential to develop risk analysis tools so players and organizations can make better decisions regarding player safety.

Failure Modes and Effects Analysis for CTE

This Failure Mode and Effects Analysis (FMEA) for CTE Diagnosis was created to identify potential failure modes in the diagnosis process and assess their possible impact on patients. The FMEA aims to provide decision-makers insight into some of the essential points in CTE diagnosis, leading to better decision-making and risk mitigation strategies.

The rationale behind using this FMEA is to identify potential failures, understand their effects, asses the causes, and implement controls to decrease the likelihood of those failures.  The Risk Priority Number (RPN) is calculated by multiplying the Severity (S), Occurrence (0), and Detection (D).  The higher the RPN, the higher the priority for addressing that risk.

The FMEA table below provides an example of a structured overview of the CTE diagnosis process, including the potential failure modes, their effects, and how they can be managed. The goal is to minimize the risk associated with these failures and to improve CTE diagnostic accuracy and patient outcomes.

Table 1.  FMEA for CTE Diagnosis

Designing an FMEA

            Utilizing an FMEA can be an effective mechanism for identifying risk and risk mitigation opportunities. FMEAs are designed through brainstorming sessions with industry leaders and knowledgeable individuals. Process mapping occurs to create a plan to find and eliminate potential failures.  Determining the steps in the process is essential and provides the initial framework for the team to complete the rest of the chart (Dziak, 2023).  Next, the team will explore various failure modes, their occurrence, and severity.  Most FMEAs use a ranking system of 1-10, with 1 being the least severe and 10 being the most serious. The team will also determine the potential root cause of each failure and the likelihood of the failure occurring.  These rankings are used to calculate the RPN. The systematic approach of creating and using an FMEA provides precision and data analysis in the decision-making process (Dziak, 2023).

Intervention Strategy

The primary focus of an intervention strategy should be preventing CTE.  The organization can support this through rule changes that lessen or prevent impacts leading to repetitive head trauma and improved equipment to enhance player safety.  Early detection also must be part of an intervention strategy. New technology is being developed that can register the impact of blows to the head and provide crucial data that allows players to be aware of how much head trauma they have accumulated. Due to the repetitive nature of CTE, it is essential to accurately identify players at risk so that appropriate precautions can be taken. Ongoing monitoring also needs to be conducted.  This is paramount for players who have suffered a concussion or are in concussion protocol. All measures need the organization's full support so players can see that CTE and player safety are important on all levels.

Benefits of the Risk Analysis Tool for CTE

Utilizing an FMEA provides healthcare providers and decision-makers with a structured framework for managing the risk associated with CTE. FMEAs can be designed using quantitative data from peer-reviewed studies and industry experts. An added benefit of utilizing an FMEA is that as more data becomes available, the document can be updated to incorporate the latest information and industry standards. Researchers in CTE are becoming more knowledgeable and have improved techniques and procedures to understand the disease better. 

FMEAs also ensure that resources to combat CTE are deployed efficiently and effectively. The RPN helps to identify high-risk areas and can be the organization's focus. Improving control and detection methods can help lower RPN scores.

Conclusion

Implementing an FMEA is a powerful and practical tool for addressing the risks associated with CTE in football. Organizations can make data-driven decisions prioritizing player safety and well-being by systematically identifying potential failure modes and assessing their impact. The structured approach of an FMEA enables organizations to proactively address high-risk areas, reduce the likelihood of diagnostic errors, and improve early detection and intervention methods for CTE. With the support of industry leaders, medical experts, and continuous updates based on the latest research, a well-executed FMEA can significantly enhance both the short-term and long-term health outcomes of current and former football players. By leveraging this tool, sports organizations demonstrate a commitment to player safety and lead the way in mitigating the risks of CTE, ensuring a safer and more informed future for football.

References

Dziak, M. (2023). Failure mode and effects analysis (FMEA). Salem Press Encyclopedia.

LeClair, J., Weuve, J., Fox, M. P., Mez, J., Alosco, M. L., Nowinski, C., McKee, A., & Tripodis, Y. (2022). Relationship between level of American football playing and diagnosis of chronic traumatic encephalopathy in a selection bias analysis. American Journal of Epidemiology, 191(8), 1429–1443. https://doi.org/10.1093/aje/kwac075

Marrero, J., & Dlugasch, L. (2024). Chronic traumatic encephalopathy and traumatic brain injury. American Nurse Journal, 19(5), 06–11. https://doi.org/10.51256/anj052406