King-Devick Sensitivity and Specificity to Concussion in Collegiate Athletes.

Area of Science:

• Sports Medicine
• Neurology
• Ophthalmology

Background:

• The King-Devick (K-D) test is a tool used to detect oculomotor impairments following a concussion.
• The diagnostic accuracy of the K-D test over time has not been previously evaluated.

Purpose of the Study:

• To assess the sensitivity and specificity of the K-D test at various time points post-concussion (0-6 hours, 24-48 hours, RTP protocol, 6 months).
• To compare K-D test outcomes between concussed and non-concussed athletes, considering confounding factors.
• To evaluate the impact of test administration mode (iPad vs. card system) on diagnostic accuracy.

Main Methods:

• Retrospective, cross-sectional study design involving 320 athletes with concussion and 1239 without.
• Receiver operator characteristic (ROC) curve and area under the curve (AUC) analyses were used to determine diagnostic accuracy.
• Cutoff scores for 80% and 70% sensitivity were identified, and analyses were repeated with confounding factors.

Main Results:

• The K-D test demonstrated significant diagnostic accuracy from 0-6 hours (AUC=0.724) and 24-48 hours (AUC=0.701) post-concussion, with accuracy decreasing at later time points.
• The test was not significantly accurate at the asymptomatic stage (AUC=0.513).
• iPad administration showed a higher AUC (0.800) compared to the card system (0.646).

Conclusions:

• The King-Devick test is most accurate in the initial 48 hours following a concussion.
• Diagnostic accuracy diminishes over subsequent post-concussion periods.
• iPad administration of the K-D test improves its diagnostic utility compared to traditional methods.