Sensitivity of the Concussion Assessment Battery

Broglio, Steven P.; Macciocchi, Stephen N.; Ferrara, Michael S.

doi:10.1227/01.neu.0000255479.90999.c0

Cited by 293 publications

(240 citation statements)

References 24 publications

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“…11,24,25 The clinician must be aware of these potential misclassifications (either false-positives or false-negatives) when using the ImPACT battery. Specifically, a false-positive result would lead to more conservative management of a concussed athlete.…”

Section: Discussionmentioning

confidence: 99%

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ImPact Test-Retest Reliability: Reliably Unreliable?

Resch

Driscoll

McCaffrey

et al. 2013

Journal of Athletic Training

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116

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Context: Computerized neuropsychological testing is commonly used in the assessment and management of sport-related concussion. Even though computerized testing is widespread, psychometric evidence for test-retest reliability is somewhat limited. Additional evidence for test-retest reliability is needed to optimize clinical decision making after concussion.Objective: To document test-retest reliability for a commercially available computerized neuropsychological test battery (ImPACT) using 2 different clinically relevant time intervals.Design: Cross-sectional study. Setting: Two research laboratories.Patients or Other Participants: Group 1 (n ¼ 46) consisted of 25 men and 21 women (age ¼ 22.4 6 1.89 years). Group 2 (n ¼ 45) consisted of 17 men and 28 women (age ¼ 20.9 6 1.72 years).Intervention(s): Both groups completed ImPACT forms 1, 2, and 3, which were delivered sequentially either at 1-week intervals (group 1) or at baseline, day 45, and day 50 (group 2). Group 2 also completed the Green Word Memory Test (WMT) as a measure of effort.Main Outcome Measures: Intraclass correlation coefficients (ICCs) were calculated for the composite scores of ImPACT between time points. Repeated-measures analysis of variance was used to evaluate changes in ImPACT and WMT results over time.Results: The ICC values for group 1 ranged from 0.26 to 0.88 for the 4 ImPACT composite scores. The ICC values for group 2 ranged from 0.37 to 0.76. In group 1, ImPACT classified 37.0% and 46.0% of healthy participants as impaired at time points 2 and 3, respectively. In group 2, ImPACT classified 22.2% and 28.9% of healthy participants as impaired at time points 2 and 3, respectively.Conclusions: We found variable test-retest reliability for ImPACT metrics. Visual motor speed and reaction time demonstrated greater reliability than verbal and visual memory. Our current data support a multifaceted approach to concussion assessment using clinical examinations, symptom reports, cognitive testing, and balance assessment.Key Words: intraclass correlation, concussions, mild traumatic brain injuries, neuropsychological testing, athletes Key PointsImPACT had strong to weak test-retest reliability over time, consistent with the results of previous studies. Reliability was greater for the visual motor speed and reaction time subscores than for the verbal and visual memory subscores. Computerized neuropsychological testing is only 1 component of a multifaceted concussion-management program that uses all appropriate tools in clinical decision making.

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Section: Discussionmentioning

confidence: 99%

“…Clinicians should recognize that a computerized neuropsychological test such as ImPACT is only 1 component of a concussionmanagement protocol and use all appropriate tools in clinical decision making and return-to-play decisions. 2,7,8,24 …”

Section: Discussionmentioning

confidence: 99%

ImPact Test-Retest Reliability: Reliably Unreliable?

Resch

Driscoll

McCaffrey

et al. 2013

Journal of Athletic Training

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116

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“…Assessment in sports concussion has recognized the need to move beyond traditional neuropsychological assessment with the development of more tailored assessment tools in the athlete with concussion (Broglio et al, 2007;Parker et al, 2007). Such assessments are also taking advantage of computerized and virtual assessment techniques as well as the ability to automate the assessment (Cernich et al, 2007;Iverson et al, 2005;Schatz & Putz, 2006;Slobounov et al, 2006).…”

Section: Ecological Validity Of the Clinical Neuropsychological Approachmentioning

confidence: 99%

Neuropsychology and clinical neuroscience of persistent post-concussive syndrome

Bigler

2007

J Int Neuropsychol Soc

355

248

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On the mild end of the acquired brain injury spectrum, the terms concussion and mild traumatic brain injury (mTBI) have been used interchangeably, where persistent post-concussive syndrome (PPCS) has been a label given when symptoms persist for more than three months post-concussion. Whereas a brief history of concussion research is overviewed, the focus of this review is on the current status of PPCS as a clinical entity from the perspective of recent advances in the biomechanical modeling of concussion in human and animal studies, particularly directed at a better understanding of the neuropathology associated with concussion. These studies implicate common regions of injury, including the upper brainstem, base of the frontal lobe, hypothalamic-pituitary axis, medial temporal lobe, fornix, and corpus callosum. Limitations of current neuropsychological techniques for the clinical assessment of memory and executive function are explored and recommendations for improved research designs offered, that may enhance the study of long-term neuropsychological sequelae of concussion. (JINS, 2008, 14, 1-22.)

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“…This may be of importance, given evidence that the greater the number of changes present in the subcategories, the higher the likelihood of neurophysiologic and balance changes. 4,24,41 Specifically, Iverson et al 24 indicated that athletes with concussion are 47 times more likely to have 2 or more declines on the ImPACT and/ or Postconcussion Symptom Scale than nonconcussed athletes. Although having 2 more declines on the ImPACT does not guarantee that an athlete has sustained a concussion, this finding suggests that neurocognitive deficits associated with concussion might have been present in these athletes.…”

Section: Discussion Ementioning

confidence: 99%

“…It is recommended that athletes undergo baseline testing in these areas prior to the season and, if a concussion is suspected, undergo the same battery of tests so that scores may be compared. 19,33,40 According to Broglio et al, 4 there is sensitivity of 90% when using the Postconcussion Symptom Scale, neurocognitive testing, and balance testing in combination for the diagnosis of concussion.…”

mentioning

confidence: 99%