The Rey Dot Counting Test as a Tool for Detecting Suboptimal Performance in Athlete Baseline Testing

Area of Science:

• Sports Medicine
• Neuropsychology
• Concussion Management

Background:

• Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) has limitations in detecting invalid performances, with estimates suggesting up to 35% of invalid baseline tests go undetected.
• Standalone performance validity tests (PVTs) are increasingly explored as supplements to improve the accuracy of cognitive assessments.

Purpose of the Study:

• To evaluate the effectiveness of the Rey Dot Counting Test (DCT), a standalone PVT, in identifying suboptimal effort among college athletes.
• To compare the detection rates of suboptimal effort between ImPACT's embedded validity measures (EVMs) and the DCT.

Main Methods:

• A cohort of 1,213 college athletes completed a preseason baseline assessment including ImPACT and the Rey Dot Counting Test (DCT).
• Suboptimal effort was defined based on established criteria for both ImPACT EVMs and the DCT.

Main Results:

• 69 athletes (5.69%) exhibited suboptimal effort on either ImPACT or the DCT.
• The DCT identified significantly more cases of suboptimal effort (n=50) compared to ImPACT (n=21).
• Significant differences were observed across all four ImPACT neurocognitive domains between athletes with adequate and suboptimal effort on the DCT.

Conclusions:

• The Rey Dot Counting Test (DCT) is effective in detecting suboptimal effort that may be missed by ImPACT's embedded validity measures (EVMs).
• Incorporating standalone PVTs like the DCT can enhance the accuracy of concussion baseline assessments in college athletes.