title: Utility of repeated assessment after invalid baseline neurocognitive test performance.
abstract: BACKGROUND
  Although the prevalence of invalid baseline neurocognitive testing has been documented, and repeated administration after obtaining invalid results is recommended, no empirical data are available on the utility of repeated assessment after obtaining invalid baseline results.
  
  
  OBJECTIVE
  To document the utility of readministering neurocognitive testing after an invalid baseline test.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Schools, colleges, and universities.
  
  
  METHODS
  A total of 156 athletes who obtained invalid results on ImPACT baseline neurocognitive testing and were readministered the ImPACT baseline test within a 2-week period (mean = 4 days).
  
  
  METHODS
  Overall prevalence of invalid results on reassessment, specific invalidity indicators at initial and follow-up baseline, dependent-samples analysis of variance, with Bonferroni correction for multiple comparisons.
  
  
  RESULTS
  Reassessment resulted in valid test results for 87.2% of the sample. Poor performance on the design memory and three-letter subscales were the most common reasons for athletes obtaining an invalid baseline result, on both the initial assessment and the reassessment. Significant improvements were noted on all ImPACT composite scores except for reaction time on reassessment. Of note, 40% of athletes showed slower reaction time scores on reassessment, perhaps reflecting a more cautious approach taken the second time. Invalid results were more likely to be obtained by athletes with a self-reported history of attention-deficit disorder or learning disability on reassessments (35%) than on initial baseline assessments (10%).
  
  
  CONCLUSIONS
  Repeat assessment after the initial invalid baseline performance yielded valid results in nearly 90% of cases. Invalid results on a follow-up assessment may be influenced by a history of attention-deficit disorder or learning disability, the skills and abilities of the individual, or a particular test-taking approach; in these cases, a third assessment may not be useful.
authors.affiliation: Saint Joseph's University, Philadelphia, PA;
authors.forename: Philip
authors.initials: P
authors.lastname: Schatz
authors.forename: Timothy
authors.initials: T
authors.lastname: Kelley
authors.forename: Summer D
authors.initials: SD
authors.lastname: Ott
authors.forename: Gary S
authors.initials: GS
authors.lastname: Solomon
authors.forename: R J
authors.initials: RJ
authors.lastname: Elbin
authors.forename: Kate
authors.initials: K
authors.lastname: Higgins
authors.forename: Rosemarie Scolaro
authors.initials: RS
authors.lastname: Moser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D056352:Athletes / Q000523:psychology*; D001265:Athletic Injuries / Q000175:diagnosis* / Q000523:psychology; D001924:Brain Concussion / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D003951:Diagnostic Errors / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011930:Reaction Time / Q000502:physiology; D015203:Reproducibility of Results; D058013:Test Taking Skills; D055815:Young Adult
keywords: ImPACT; baseline testing; concussion testing; head injuries; invalid baseline; neuropsychological testing