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Institutionally Based ImPACT Test® Normative Values May Differ from Manufacturer-Provided Normative Values.

Samuel R Walton1,2, Donna K Broshek3, Jason R Freeman4

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Archives of Clinical Neuropsychology : the Official Journal of the National Academy of Neuropsychologists
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Summary

Comparing post-concussion Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) results to institution-specific norms, not manufacturer data, is crucial. This study found significant differences, highlighting the risk of misclassifying neurocognitive impairment in athletes.

Keywords:
Baseline testingConcussionNeuropsychological assessmentNormative data

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Area of Science:

  • Sports Medicine
  • Neuroscience
  • Clinical Psychology

Background:

  • Computerized neurocognitive assessments are used to evaluate concussions.
  • The validity of using manufacturer-provided normative data versus institution-specific data for post-concussion assessment is debated.
  • Manufacturer norms may not accurately reflect the performance of specific athlete populations.

Purpose of the Study:

  • To compare institutionally derived normative data with manufacturer-provided normative data from ImPACT® Applications.
  • To assess the potential for misclassification of neurocognitive impairment in collegiate athletes.
  • To evaluate the utility of baseline testing versus manufacturer norms for concussion management.

Main Methods:

  • A cohort study involving 952 NCAA Division 1 university student athletes.
  • Participants completed baseline Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) assessments.
  • Data were analyzed by comparing institutionally derived norms to manufacturer norms for ImPACT clinical composite scores (Verbal Memory, Visual Memory, Visual Motor Speed, Reaction Time) using Chi-squared analysis.

Main Results:

  • Institutionally derived norms showed significantly different performance distributions compared to manufacturer norms (p < 0.001).
  • Athletes performed above average on Verbal Memory, Visual Memory, and Visual Motor Speed, and slightly below average on Reaction Time when compared to manufacturer data.
  • Significant differences were observed across all ImPACT clinical composite scores.

Conclusions:

  • There are significant differences between manufacturer-provided and institutionally derived normative data for ImPACT assessments.
  • Using manufacturer norms may lead to an increased risk of misclassifying neurocognitive impairment in athletes post-concussion.
  • The study supports the use of institutionally derived norms or baseline testing for accurate concussion assessment.