Evidence map›Paper›PMID 33315231›Full record

ArticleSports medicine (Auckland, N.Z.)2021

Sensitivity and Specificity of Computer-Based Neurocognitive Tests in Sport-Related Concussion: Findings from the NCAA-DoD CARE Consortium.

Lauren L Czerniak, Spencer W Liebel, Gian-Gabriel P Garcia, Mariel S Lavieri, Michael A McCrea, Thomas W McAllister, Steven P Broglio, CARE Consortium Investigators

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In one paragraph

Article in Sports medicine (Auckland, N.Z.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Lauren L CzerniakDepartment of Industrial and Operations Engineering, University of Michigan, 1205 Beal Ave, Ann Arbor, MI, 48109, USA. czernL@umich.edu.ORCID http://orcid.org/0000-0003-4379-2004
Spencer W LiebelDepartment of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA.ORCID http://orcid.org/0000-0002-7036-4198
Gian-Gabriel P GarciaMassachusetts General Hospital Institute for Technology Assessment, Harvard Medical School, Boston, MA, 02114, USA.ORCID http://orcid.org/0000-0001-9315-0195
Mariel S LavieriDepartment of Industrial and Operations Engineering, University of Michigan, 1205 Beal Ave, Ann Arbor, MI, 48109, USA.
Michael A McCreaDepartment of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Thomas W McAllisterDepartment of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
Steven P BroglioMichigan Concussion Center, University of Michigan, Ann Arbor, MI, USA.ORCID http://orcid.org/0000-0002-2282-9325
CARE Consortium Investigators

Funding

Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Program W81XWH-14-2-0151
6 · The paper itself

Abstract

backgroundTo optimally care for concussed individuals, a multi-dimensional approach is critical and a key component of this assessment in the athletic environment is computer-based neurocognitive testing. However, there continues to be concerns about the reliability and validity of these testing tools. The purpose of this study was to determine the sensitivity and specificity of three common computer-based neurocognitive tests (Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT], CNS Vital Signs, and CogState Computerized Assessment Tool [CCAT]), to provide guidance on their clinical utility.

methodsThis study analyzed assessments from a cohort of collegiate athletes and non-varsity cadets from the NCAA-DoD CARE Consortium. The data were collected from 2014-2018. Study participants were divided into two testing groups [concussed, n = 1414 (baseline/24-48 h) and healthy, n = 8305 (baseline/baseline)]. For each test type, change scores were calculated for the components of interest. Then, the Normative Change method, which used normative data published in a similar cohort, and the Reliable Change Index (RCI) method were used to determine if the change scores were significant.

resultsUsing the Normative Change method, ImPACT performed best with an 87.5%-confidence interval and 1 number of components failed (NCF; sensitivity = 0.583, specificity = 0.625, F1 = 0.308). CNS Vital Signs performed best with a 90%-confidence interval and 1 NCF (sensitivity = 0.587, specificity = 0.532, F1 = 0.314). CCAT performed best when using a 75%-confidence interval and 2 NCF (sensitivity = 0.513, specificity = 0.715, F1 = 0.290). When using the RCI method, ImPACT performed best with an 87.5%-confidence interval and 1 NCF (sensitivity = 0.626, specificity = 0.559, F1 = 0.297).

conclusionWhen considering all three computer-based neurocognitive tests, the overall low sensitivity and specificity results provide additional evidence for the use of a multi-dimensional assessment for concussion diagnosis, including symptom evaluation, postural control assessment, neuropsychological status, and other functional assessments.

Indexed as

Athletic InjuriesBrain ConcussionSportsComputersHumansMental Status and Dementia TestsNeuropsychological TestsReproducibility of Results

Identifiers

PMID33315231

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.