Test-Retest Reliability of a Computerized Concussion Test

Abstract

Background:Neurocognitive testing is an important concussion evaluation tool, but for neurocognitive tests to be useful, their psychometric properties must be well established. Test-retest reliability of computerized neurocognitive tests can influence their clinical utility. The reliability for a commonly used computerized neurocognitive test, CNS Vital Signs, is not well established. The purpose of this study was to examine test-retest reliability and reliable change indices for CNS Vital Signs in a healthy, physically active college population.Hypothesis:CNS Vital Signs yields acceptable test-retest reliability, with greater reliability between the second and third test administration compared with between the first and second administration.Study Design:Cohort study.Level of Evidence:Level 3.Methods:Forty healthy, active volunteers (16 men, 24 women; mean age, 21.05 ± 2.17 years) reported to a clinical laboratory for 3 sessions, 1 week apart. At each session, participants were administered CNS Vital Signs. Outcomes included standard scores for the following CNS Vital Signs domains: verbal memory, visual memory, psychomotor speed, cognitive flexibility, complex attention, processing speed, reaction time, executive functioning, and reasoning.Results:Participants performed significantly better on the second session and/or third session than they did on the first testing session on 6 of 9 neurocognitive domains. Pearson r test-retest correlations between sessions ranged from 0.11 to 0.87. Intraclass correlation coefficients ranged from 0.10 to 0.86.Conclusion:Clinicians should consider using reliable change indices to account for practice effects, identify meaningful score changes due to pathology, and inform clinical decisions.Clinical Relevance:This study highlights the importance of clinicians understanding the psychometric properties of computerized neurocognitive tests when using them in the management of sport-related concussion. If CNS Vital Signs is administered twice within a small time frame (such as 1 week), athletes should be expected to improve between the first and second administration.

White Matter Changes Related to Subconcussive Impact Frequency during a Single Season of High School Football

“…The validity and reliability of CNS Vital Signs has been previously described. 10,11 Main outcome measures included standard scores for the following domains: verbal memory, visual memory, psychomotor speed, cognitive flexibility, complex attention, processing speed, reasoning, reaction time, and executive functioning. Standard scores are based on a normative dataset that matches participants by age.…”

Functional connectivity changes in core resting state networks are associated with cognitive performance in systemic lupus erythematosus

“…Also, the cognitive test of choice, CNS‐VS is a validated computerized test but has not previously been validated for SLE‐patients. The test is however based on well‐known neurocognitive tests and has been evaluated for several different neuropsychiatric conditions, such as Alzheimer's disease and multiple sclerosis (Littleton, Schmidt, et al, ; Littleton, Register‐Mihalik, et al, ; Meskal et al, ).…”

“…CNS‐VS has previously been tested and validated in various distinct neuropsychiatric conditions such as traumatic brain injury, dementia, in patients with Attention Deficit/Hyperactivity Disorder (ADHD; Gualtieri & Johnson, , ; Littleton, Register‐Mihalik, & Guskiewicz, ), and used in the evaluation of cognitive function in patients with multiple sclerosis and in brain tumor (Meskal, Gehring, van der Linden, Rutten, & Sitskoorn, ; Papathanasiou et al, ).…”

“…Five crucial cognitive domains were selected for further analysis: memory domain, psychomotor speed, reaction time, complex attention, and cognitive flexibility (Gualtieri & Johnson, ; Littleton, Register‐Mihalik, et al, ). All results were converted into Z ‐scores.…”

Reliability of Computerized Neurocognitive Tests for Concussion Assessment: A Meta-Analysis

“…Furthermore, the proportion of outcomes with acceptable reliability was calculated for each CNT. Only 2 studies 21,40 examined the reliability of the CNS-VS test, whereas only a single study 11 examined the reliability of Headminder. The samples for these CNTs were not included in the overall meta-analysis because of the small sizes.…”