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Minimal Detectable Change for the ImPACT Test Administered Remotely
Kristen G Quigley1, Madison R Taylor1, Dustin Hopfe1
1Neuromechanics Laboratory, School of Public Health, University of Nevada, Reno.
Context:
Immediate Postconcussion Assessment and Cognitive Testing (ImPACT) is one of the most widely used computerized neurocognitive assessment batteries in athletics and serves as both a baseline and postinjury assessment. It has become increasingly popular to administer the ImPACT baseline test in an unsupervised remote environment; however, whether the lack of supervision affects the test-retest reliability is unknown.
Objective:
To establish the minimal detectable change (MDC) of composite scores from the ImPACT test when administered to National Collegiate Athletic Association Division I student-athletes in an unsupervised remote environment before 2 consecutive athletic seasons.
Design:
Cross-sectional study.
Setting:
Participants were provided with a unique link and detailed written instructions on how to complete the ImPACT test at home.
Patients Or Other Participants:
Division I student-athletes.
Main Outcome Measure(S):
Remote baseline ImPACT results from the 2020-2021 and 2021-2022 athletic seasons were analyzed. The MDC was calculated at the 95%, 90%, and 80% CIs for each of the ImPACT composite scores as well as the average and SD.
Results:
The MDC at the 95% CI was 18.6 for the verbal memory composite score, 24.44 for visual memory, 8.76 for visual motor, 0.14 for reaction time, and 6.13 for impulse control. One-way repeated-measures multivariate analysis of variance, repeated-measures analysis of variance, and Wilcoxon signed ranks tests suggested no difference in the composite scores and impulse control between time points.
Conclusions:
The ImPACT composite scores and impulse control did not change between the 2 remote testing time points when administered approximately 1 year apart. Our study suggests that the MDC serves as a clinician's guide for evaluating changes in ImPACT baseline scores and in making clinical judgments on sport-related concussion when the test is administered at home.
