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Test-retest reliability of computerized concussion assessment programs.

Steven P Broglio1, Michael S Ferrara, Stephen N Macciocchi

  • 1University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, 906 South Goodwin Avenue, Urbana, IL 61801, USA. broglio@uiuc.edu

Journal of Athletic Training
|January 5, 2008
PubMed
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Computer-based concussion tests show low to moderate reliability. These neurocognitive assessments are crucial but should be part of a broader concussion evaluation strategy.

Area of Science:

  • Neuroscience
  • Sports Medicine
  • Clinical Psychology

Background:

  • Computer-based neurocognitive assessment programs are widely used for concussion diagnosis and management.
  • Clinician adoption is often based on developer-provided test-retest reliability data.

Purpose of the Study:

  • To evaluate the test-retest reliability of three commercial computer-based neurocognitive assessments.
  • Assessments were examined within clinically relevant time frames.

Main Methods:

  • A repeated-measures design was employed in a research laboratory setting.
  • 118 healthy student volunteers completed ImPACT, Concussion Sentinel, and Headminder Concussion Resolution Index tests at baseline, day 45, and day 50.
  • The Green Memory and Concentration Test assessed participant effort; intraclass correlation coefficients estimated reliability.
Keywords:
Concussion Resolution IndexConcussion SentinelImPACTeffortintraclass correlation coefficient

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Main Results:

  • Test-retest reliability coefficients (intraclass correlation coefficients) ranged from low to moderate across all three programs.
  • Reliability estimates between baseline and day 45 varied: ImPACT (.15–.39), Concussion Sentinel (.23–.65), and Concussion Resolution Index (.15–.66).
  • Reliability estimates between day 45 and day 50 also showed low to moderate coefficients, with all participants demonstrating high effort.

Conclusions:

  • Contemporary computer-based concussion assessment tools exhibit low to moderate test-retest reliability.
  • Findings were not attributable to poor effort or other performance factors.
  • Neurocognitive evaluation remains a vital component of comprehensive concussion assessment, prioritizing scores with higher reliability.