title: Double cross-validation and improved sensitivity of the rapid screen of mild traumatic brain injury.
abstract: This study aimed to replicate and cross-validate the Rapid Screen of Concussion (RSC) for diagnosing mild TBI (mTBI). One hundred (81 male, 19 female) cases of mTBI and 35 (23 male and 12 female) cases of orthopaedic injuries were tested within 24 hr of injury. Double cross-validation was used to examine whether total RSC scores obtained in the current sample, generalised to one previously reported. In the new sample, mTBI patients answered fewer orientation questions, recalled fewer words on the learning trial and after a delay, judged fewer sentences in 2 min, and completed fewer symbols in the Digit Symbol Substitution Test than orthopaedic controls. The formulae and cut-offs developed on the original and new samples produced similar sensitivity and overall correct classification rates. Inclusion of the Digit Symbol Substitution Test performance of the new sample improved the sensitivity (80.2%) and specificity (82.6%) in males. It did not improve the correct classification rate in females, which was 89.5% sensitivity and 91.7% specificity before the inclusion of the Digit Symbol Substitution Test. Taken together, these results indicate that a combined score on this 12-min screen yields a measure of level of brain impairment up to 24 hr after mTBI.
authors.affiliation: Cognitive Psychophysiology Laboratory, Edith Cavell Building, Medical School, Herston Road, Herston, Brisbane, Queensland, 4006, Australia. comerf@psy.uq.edu.au
authors.forename: Veronica Eileen
authors.initials: VE
authors.lastname: De Monte
authors.forename: Gina Malke
authors.initials: GM
authors.lastname: Geffen
authors.forename: Christopher Randall
authors.initials: CR
authors.lastname: May
authors.forename: Ken
authors.initials: K
authors.lastname: McFarland
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001924:Brain Concussion / Q000175:diagnosis*; D001930:Brain Injuries / Q000145:classification / Q000150:complications / Q000175:diagnosis*; D016009:Chi-Square Distribution; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013223:Statistics as Topic; D015599:Trauma Severity Indices