Evidence for added value of baseline testing in computer-based cognitive assessment
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Published on: January 30, 2026
Tresa M Roebuck-Spencer1, Andrea S Vincent, Robert E Schlegel
1Cognitive Science Research Center, University of Oklahoma, 3200 Marshall Avenue, Suite 260, Norman, OK 73072, USA. tresa@ou.edu
Context:
Large-scale baseline cognitive assessment for individuals at risk for concussion is a common part of the protocol for concussion-surveillance programs, particularly in sports. Baseline cognitive testing is also being conducted in US military service members before deployment. Recently, the incremental validity of large-scale baseline cognitive assessment has been questioned.
Objective:
To examine the added value of baseline cognitive testing in computer-based neuropsychological assessment by comparing 2 methods of classifying atypical performance in a presumed healthy sample.
Design:
Cross-sectional study.
Setting:
Military base.
Patients Or Other Participants:
Military service members who took the Automated Neuropsychological Assessment Matrix (ANAM) before and after deployment (n = 8002).
Main Outcome Measure(S):
Rates of atypical performance in this healthy, active-duty sample were determined first by comparing postdeployment scores with a military normative database and then with each individual's personal baseline performance using a reliable change index.
Results:
Overall rates of atypical performance were comparable across these 2 methods. However, these methods were highly discordant in terms of which individuals were classified as atypical. When norm-referenced methods were used, 2.6% of individuals classified as normal actually demonstrated declines from baseline. Further, 65.7% of individuals classified as atypical using norm-referenced scores showed no change from baseline (ie, potential false-positive findings).
Conclusions:
Knowing an individual's baseline performance is important for minimizing potential false-positive errors and reducing the risks and stresses of misdiagnosis.
