Test-retest reliability of computerized concussion assessment programs.
BACKGROUND
Computer-based neurocognitive assessment programs commonly are used to assist in concussion diagnosis and management. These tests have been adopted readily by many clinicians based on existing test-retest reliability data provided by test developers.


OBJECTIVE
To examine the test-retest reliability of 3 commercially available computer-based neurocognitive assessments using clinically relevant time frames.


METHODS
Repeated-measures design.


METHODS
Research laboratory.


METHODS
118 healthy student volunteers.


METHODS
The participants completed the ImPACT, Concussion Sentinel, and Headminder Concussion Resolution Index tests on 3 days: baseline, day 45, and day 50. Each participant also completed the Green Memory and Concentration Test to evaluate effort. Intraclass correlation coefficients were calculated for all output scores generated by each computer program as an estimate of test-retest reliability.


RESULTS
The intraclass correlation coefficient estimates from baseline to day 45 assessments ranged from .15 to .39 on the ImPACT, .23 to .65 on the Concussion Sentinel, and .15 to .66 on the Concussion Resolution Index. The intraclass correlation coefficient estimates from the day 45 to day 50 assessments ranged from .39 to .61 on the ImPACT, .39 to .66 on the Concussion Sentinel, and .03 to .66 on the Concussion Resolution Index. All participants demonstrated high levels of effort on all days of testing, according to Memory and Concentration Test interpretive guidelines.


CONCLUSIONS
Three contemporary computer-based concussion assessment programs evidenced low to moderate test-retest reliability coefficients. Our findings do not appear to be due to suboptimal effort or other factors related to poor test performance, because persons identified by individual programs as having poor baseline data were excluded from the analyses. The neurocognitive evaluation should continue to be part of a multifaceted concussion assessment program, with priority given to those scores showing the highest reliability.
Broglio
Steven P
SP
University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, 906 South Goodwin Avenue, Urbana, IL 61801, USA. broglio@uiuc.edu
Ferrara
Michael S
MS
Macciocchi
Stephen N
SN
Baumgartner
Ted A
TA
Elliott
Ronald
R
D000328:Adult; D000704:Analysis of Variance; D001924:Brain Concussion / Q000188:drug therapy*; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D015203:Reproducibility of Results