Does baseline concussion testing really reduce risks to athletes?

June 1, 2011

Baseline concussion tests given to hundreds of thousands of athletes might, paradoxically, increase risks in some cases, according to a Loyola University Health System researcher.

The tests likely have a high "false negative" rate, meaning a test shows an athlete has recovered, when in fact he or she is still experiencing cognitive impairments from the .

This could increase risks by returning to play athletes who might otherwise be withheld for a longer period, neuropsychologist Christopher Randolph, PhD, writes in a recent issue of the journal Current Reports.

Baseline concussion testing is mandatory in many football, hockey and other programs, from to the pros. Such testing provides a baseline score of an athlete's attention span, , , etc. If the athlete suffers a concussion, he or she retakes the test. If there is a large decrease in the post-concussion score, the athlete typically is benched until the score increases.

Randolph examined the most common baseline test, called ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). The 20-minute test is taken on a computer.

"There is no evidence to suggest that the use of baseline testing alters any risk from sport-related concussion, nor is there even a good rationale as to how such tests might influence outcome," Randolph writes.

In searching the scientific literature, Randolph could not find a single prospective, controlled study of the current version of ImPACT (version 2.0). Such a study would involve baseline testing a large sample of athletes and then retesting concussed athletes in comparison with noninjured teammates. There was a single prospective, controlled study of an earlier version (1.0), but that study had several serious flaws, Randolph writes.

Studies by independent researchers have found that the reliability of ImPACT testing "appears to be far too low to be useful for individual decision making," Randolph writes.

Using baseline testing with poor sensitivity and inadequate reliability could create a false sense of security that an athlete has recovered from a concussion.

Rather than relying on ImPACT or other baseline tests, team medical personnel "may be better advised to rely upon their own clinical judgment, in conjunction with a validated symptom checklist, in making return-to-play decisions," Randolph writes.

Related Stories

Recommended for you

High-fat diet in pregnancy can cause mental health problems in offspring

July 21, 2017
A high-fat diet not only creates health problems for expectant mothers, but new research in an animal model suggests it alters the development of the brain and endocrine system of their offspring and has a long-term impact ...

To combat teen smoking, health experts recommend R ratings for movies that depict tobacco use

July 21, 2017
Public health experts have an unusual suggestion for reducing teen smoking: Give just about any movie that depicts tobacco use an automatic R rating.

Why sugary drinks and protein-rich meals don't go well together

July 20, 2017
Having a sugar-sweetened drink with a high-protein meal may negatively affect energy balance, alter food preferences and cause the body to store more fat, according to a study published in the open access journal BMC Nutrition.

Opioids and obesity, not 'despair deaths,' raising mortality rates for white Americans

July 20, 2017
Drug-related deaths among middle-aged white men increased more than 25-fold between 1980 and 2014, with the bulk of that spike occurring since the mid-1990s when addictive prescription opioids became broadly available, according ...

Aging Americans enjoy longer life, better health when avoiding three risky behaviors

July 20, 2017
We've heard it before from our doctors and other health experts: Keep your weight down, don't smoke and cut back on the alcohol if you want to live longer.

Parents have critical role in preventing teen drinking

July 20, 2017
Fewer teenagers are drinking alcohol but more needs to be done to curb the drinking habits of Australian school students, based on the findings of the latest study by Adelaide researchers.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.