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The Inter-Tester and Test-Retest Reliability of the Off-Field SCAT6 Assessment Tool In An Adult Population.

Tom McKeever¹, Michael Leavitt, Stephanie Valentin

¹Author Affiliations: School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK (Mr McKeever, Drs Leavitt, and Valentin, Mr Hurley, and Mr Fraser); and Research Centre for Health, Glasgow Caledonian University, Glasgow, UK (Dr Hamilton).

The Journal of Head Trauma Rehabilitation

|August 27, 2025

Summary

This summary is machine-generated.

The Sports Concussion Assessment Tool-6 (SCAT6) shows good to excellent reliability for some domains in non-concussed adults. However, tester error scoring and overall consistency require improvement for accurate concussion assessment.

Keywords:

concussion management mild traumatic brain injury sports concussion assessment tool-6 sports-related concussion

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Area of Science:

Sports Medicine
Neurology
Clinical Assessment

Background:

The Sports Concussion Assessment Tool-6 (SCAT6) is a critical tool for concussion diagnosis.
No prior data existed on the repeatability and reliability of the SCAT6 in non-concussed adults.
Evaluating SCAT6 reliability is essential for its effective clinical application.

Purpose of the Study:

To assess the inter-tester and intra-tester reliability of the off-field SCAT6.
To identify domains within the SCAT6 that demonstrate consistent scoring in a healthy adult population.
To provide foundational data for the SCAT6's use in concussion management.

Main Methods:

A reliability study design was employed with 20 active adults without recent concussion history.
Participants completed five SCAT6 assessments across three testers (inter-rater) and two time points (intra-rater).
Intraclass Correlation Coefficients (ICCs), Fleiss's kappa, and Kendall's W were used to analyze SCAT6 domain scores.

Main Results:

Inter-tester reliability was excellent for symptom number, severity, and dual-task scoring (ICC > 0.91).
Intra-tester reliability was excellent for dual-tasking (ICC = 0.943) and good for several other domains.
Poor reliability was observed for dual-task errors, Total mBESS, and Month recall, with percentage error rates up to 100%.

Conclusions:

The SCAT6 demonstrated good to excellent reliability in 4/13 (inter-tester) and 6/13 (intra-tester) domains.
Domains relying on tester error scoring showed poor reliability.
The SCAT6's consistency in scoring non-concussed individuals needs further refinement.