Test-Retest Reliability of a Computerized Concussion Test: CNS Vital Signs.
BACKGROUND
Neurocognitive testing is an important concussion evaluation tool, but for neurocognitive tests to be useful, their psychometric properties must be well established. Test-retest reliability of computerized neurocognitive tests can influence their clinical utility. The reliability for a commonly used computerized neurocognitive test, CNS Vital Signs, is not well established. The purpose of this study was to examine test-retest reliability and reliable change indices for CNS Vital Signs in a healthy, physically active college population.


OBJECTIVE
CNS Vital Signs yields acceptable test-retest reliability, with greater reliability between the second and third test administration compared with between the first and second administration.


METHODS
Cohort study.


METHODS
Level 3.


METHODS
Forty healthy, active volunteers (16 men, 24 women; mean age, 21.05 ± 2.17 years) reported to a clinical laboratory for 3 sessions, 1 week apart. At each session, participants were administered CNS Vital Signs. Outcomes included standard scores for the following CNS Vital Signs domains: verbal memory, visual memory, psychomotor speed, cognitive flexibility, complex attention, processing speed, reaction time, executive functioning, and reasoning.


RESULTS
Participants performed significantly better on the second session and/or third session than they did on the first testing session on 6 of 9 neurocognitive domains. Pearson r test-retest correlations between sessions ranged from 0.11 to 0.87. Intraclass correlation coefficients ranged from 0.10 to 0.86.


CONCLUSIONS
Clinicians should consider using reliable change indices to account for practice effects, identify meaningful score changes due to pathology, and inform clinical decisions.


CONCLUSIONS
This study highlights the importance of clinicians understanding the psychometric properties of computerized neurocognitive tests when using them in the management of sport-related concussion. If CNS Vital Signs is administered twice within a small time frame (such as 1 week), athletes should be expected to improve between the first and second administration.
The University of North Carolina at Chapel Hill Human Movement Science Curriculum, Chapel Hill, North Carolina Department of Exercise & Sport Science Department, The University of North Carolina, Chapel Hill, North Carolina Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, The University of North Carolina, Chapel Hill, North Carolina alittlet@live.unc.edu.
Ashley C
AC
Littleton
The University of North Carolina at Chapel Hill Human Movement Science Curriculum, Chapel Hill, North Carolina Department of Exercise & Sport Science Department, The University of North Carolina, Chapel Hill, North Carolina Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, The University of North Carolina, Chapel Hill, North Carolina.
Johna K
JK
Register-Mihalik
The University of North Carolina at Chapel Hill Human Movement Science Curriculum, Chapel Hill, North Carolina Department of Exercise & Sport Science Department, The University of North Carolina, Chapel Hill, North Carolina Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, The University of North Carolina, Chapel Hill, North Carolina.
Kevin M
KM
Guskiewicz
D001924:Brain Concussion / Q000175:diagnosis*; D003201:Computers; D005260:Female; D006801:Humans; D008297:Male; D008606:Mental Processes; D009483:Neuropsychological Tests; D011594:Psychometrics; D011930:Reaction Time; D012016:Reference Values; D015203:Reproducibility of Results; D055815:Young Adult
Concussion Vital Signs; cognition; computerized neurocognitive testing; concussion; psychometrics