Predicting Severity of Head Collision Events in Elite Soccer Using Preinjury Data: A Machine Learning Approach

To develop machine learning (ML) models that predict severity of head collision events (HCEs) based on preinjury variables and to investigate which variables are important to predicting severity. DESIGN: Data on HCEs were collected with respect to severity and 23 preinjury variables to create 2 datasets, a male dataset using men's tournaments and mixed dataset using men's and women's tournaments, to perform ML analysis. Machine learning analysis used a random forest classifier based on preinjury variables to predict HCE severity. SETTING: Four elite international soccer tournaments. PARTICIPANTS: Elite athletes participating in analyzed tournaments. INDEPENDENT VARIABLES: The 23 preinjury variables collected for each HCE. MAIN OUTCOME MEASURES: Predictive ability of the ML models and association of important variables. RESULTS: The ML models had an average area under the receiver operating characteristic curve for predicting HCE severity of 0.73 and 0.70 for the male and mixed datasets, respectively. The most important variables for prediction were the mechanism of injury and the event before injury. In the male dataset, the mechanisms “head-to-head” and “knee-to-head” were together significantly associated (P = 0.0244) with severity; they were not significant in the mixed dataset (P = 0.1113). In both datasets, the events “corner kicks” and “throw-ins” were together significantly associated with severity (male, P = 0.0001; mixed, P = 0.0004). CONCLUSIONS: ML models accurately predicted the severity of HCE. The mechanism and event preceding injury were most important for predicting severity of HCEs. These findings support the use of ML to inform preventative measures that will mitigate the impact of these preinjury factors on player health.