Test-retest Reliability of Creyos Test Battery in Adolescents at Risk of Concussion

Background: Creyos is a computerized neurocognitive test battery that is widely used to assess cognition. Purpose: To evaluate the test-retest reliability of Creyos subtests for adolescents. Method: Reliability was analyzed using intraclass correlation coefficients and Bland-Altman 95% limits of agreement. Linear mixed-effects models were employed to examine change in scores over time for each subtest (a) overall; and (b) by sex. Findings: Participants included 71 adolescents ages 12-18 (median age 15, 49% female) who participated in at least one sport with a high risk of concussion. Results indicated poor-to-moderate reliability and wide limits of agreement across all subtests. Learning effects were apparent on several subtests; one subtest showed learning effects for both females and males. One subtest showed a significant difference in reliability between sexes. Conclusion: Reliability was poor-to-moderate across all subtests. Generally, reliability and learning effects did not differ by sex. Given concerns about the reliability of Creyos, occupational therapists should exercise caution when interpreting test scores to inform return to school and sport management in adolescents post-concussion. In the future, randomizing the order of subtest presentation and standardizing the test administration process may provide greater insight into the reliability of Creyos in adolescents.