Development and initial validation of a digital divided-attention neurocognitive test for use in concussion...

Objective: Computerized neurocognitive tests are commonly used after a concussion injury. The use of reliable and valid tests that utilize a divided-attention task may improve assessment. Therefore, the purpose of this study is to test a digital divided-attention neurocognitive test for test-retest reliability, practise effects, and initial validity. Methods and procedures: One hundred ninety-two subjects (159 healthy, 33 concussed) were assessed utilizing the neurocognitive test. Group comparisons were made between subjects with concussions and matched controls to determine the initial sensitivity of the test. Results: Intraclass correlation coefficients remained high (greater than 0.50) across all time points tested, and practise effects were largest in first retest session but we correlated (single task: R² = 0.89, divided-attention: R² = 0.85). Subjects who had experienced concussions performed significantly worse than matched controls on both the maths computation task and shape matching task during the divided-attention test. Conclusion: The mathematical computation component of the divided-attention test yielded high reliability. Practise effects were seen between the first and second testing sessions with smaller, insignificant improvements seen thereafter. Sensitivity to injury was comparable to other digital neurocognitive tests suggesting ongoing testing is warranted.