title: Detecting cognitive impairment after concussion: sensitivity of change from baseline and normative data methods using the CogSport/Axon cognitive test battery.
abstract: Concussion-related cognitive impairments are typically evaluated with repeated neuropsychological assessments where post-injury performances are compared with pre-injury baseline data (baseline method). Many cases of concussions, however, are evaluated in the absence of baseline data by comparing post-injury performances with normative data (normative method). This study aimed to compare the sensitivity and specificity of these two methods using the CogSport/Axon test battery. Normative data and reliable change indices were computed from a non-injured athlete sample (n = 235). Test-retest data from non-injured (n = 260) and recently concussed (n = 29) athlete samples were then used to compare the two methods. The baseline method was found to be more sensitive than the normative method, and both methods had high specificity and overall correct classification rates. This suggests that while the normative method identifies most cases of recent concussions, the baseline method remains a more precise approach to assessing concussion-related cognitive impairments.
authors.affiliation: Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.
authors.forename: Andrea G
authors.initials: AG
authors.lastname: Louey
authors.affiliation: CogState Ltd., Melbourne, VIC, Australia Child Study Center, Yale University, New Haven, CT, USA.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Cromer
authors.affiliation: CogState Ltd., Melbourne, VIC, Australia.
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Schembri
authors.affiliation: The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre - Austin Campus, Heidelberg, VIC, Australia.
authors.forename: David G
authors.initials: DG
authors.lastname: Darby
authors.affiliation: CogState Ltd., Melbourne, VIC, Australia The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre - Austin Campus, Heidelberg, VIC, Australia pmaruff@cogstate.com.
authors.forename: Paul
authors.initials: P
authors.lastname: Maruff
authors.affiliation: The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre - Austin Campus, Heidelberg, VIC, Australia Centre For Health Exercise and Sports Medicine, Melbourne Physiotherapy Department, The University of Melbourne, Parkville, VIC, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Makdissi
authors.affiliation: The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre - Austin Campus, Heidelberg, VIC, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Mccrory
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001265:Athletic Injuries / Q000150:complications; D001924:Brain Concussion / Q000150:complications*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D032882:Comprehension; D003936:Diagnosis, Computer-Assisted; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards; D011597:Psychomotor Performance; D011930:Reaction Time; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Assessment; Cognition; Concussion; Injury management; Neuropsychological evaluation; mTBI