Prevalence of invalid computerized baseline neurocognitive test results in high school and collegiate athletes.
BACKGROUND
Limited data are available regarding the prevalence and nature of invalid computerized baseline neurocognitive test data.


OBJECTIVE
To identify the prevalence of invalid baselines on the desktop and online versions of ImPACT and to document the  utility of correcting for left-right (L-R) confusion on the desktop version of ImPACT.


METHODS
Cross-sectional study of independent samples of high school (HS) and collegiate athletes who completed the desktop or online versions of ImPACT. Participants or Other Participants:  A total of 3769 HS (desktop = 1617, online = 2152) and 2130 collegiate (desktop = 742, online = 1388) athletes completed preseason baseline assessments.


METHODS
Prevalence of = ImPACT validity indicators, with correction for L-R confusion (reversing left and  right mouse-click responses) on the desktop version, by test version and group. Chi-square analyses were conducted for sex and attentional or learning disorders.


RESULTS
At least 1 invalid indicator was present on 11.9% (desktop) versus 6.3% (online) of the HS baselines and  10.2% (desktop) versus 4.1% (online) of collegiate baselines; correcting for L-R confusion (desktop) decreased this overall prevalence to 8.4% (HS) and 7.5% (collegiate). Online Impulse Control scores alone yielded 0.4% (HS) and 0.9% (collegiate) invalid baselines, compared with 9.0% (HS)  and 5.4% (collegiate) on the desktop version; correcting for L-R confusion (desktop) decreased the prevalence of invalid Impulse Control scores to 5.4% (HS) and 2.6% (collegiate). Male athletes and HS athletes with attention deficit or learning disorders who took the online version were more  likely to have at least 1 invalid indicator. Utility of additional invalidity indicators is reported.


CONCLUSIONS
The online ImPACT version appeared to yield fewer invalid baseline results than did the desktop version. Identification of L-R confusion reduces the prevalence  of invalid baselines (desktop only) and the potency of Impulse Control as a validity indicator. We advise test administrators to be vigilant in identifying invalid baseline results as part of routine concussion management and prevention programs.
Department of Psychology, Saint Joseph's University, Philadelphia, PA 19131, USA. pschatz@sju.edu
Philip
P
Schatz
Rosemarie Scolaro
RS
Moser
Gary S
GS
Solomon
Summer D
SD
Ott
Robin
R
Karpf
D000293:Adolescent; D056352:Athletes; D001265:Athletic Injuries / Q000175:diagnosis*; D001924:Brain Concussion / Q000175:diagnosis* / Q000523:psychology; D001930:Brain Injuries / Q000175:diagnosis* / Q000523:psychology; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D011930:Reaction Time; D015203:Reproducibility of Results; D012574:Schools; D013334:Students; D014495:Universities; D055815:Young Adult