Examination of the Test-Retest Reliability of a Computerized Neurocognitive Test Battery

Nakayama, Yusuke; Covassin, Tracey; Schatz, Philip; Nogle, Sally; Kovan, Jeff

doi:10.1177/0363546514535901

Cited by 63 publications

(28 citation statements)

References 30 publications

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“…18 The controversy of CNT reliability is further complicated because of the wide range of reliability estimates (from as low as 0.10 to as high as 0.93) reported across studies. 7,8,11,12,[17][18][19][20][21][22][23][24][25][26][27][28][29][30] Because of the conflicting reports, a more thorough investigation of the reliability of CNT scores is necessary. Although a systematic review 10 summarizing the reliability of ImPACT scores has been previously published, this study was limited to a single CNT.…”

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confidence: 99%

Reliability of Computerized Neurocognitive Tests for Concussion Assessment: A Meta-Analysis

Farnsworth

Dargo

Ragan³

et al. 2017

Journal of Athletic Training

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Objective: Although widely used, computerized neurocognitive tests (CNTs) have been criticized because of low reliability and poor sensitivity. A systematic review was published summarizing the reliability of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores; however, this was limited to a single CNT. Expansion of the previous review to include additional CNTs and a meta-analysis is needed. Therefore, our purpose was to analyze reliability data for CNTs using meta-analysis and examine moderating factors that may influence reliability.Data Sources: A systematic literature search (key terms: reliability, computerized neurocognitive test, concussion) of electronic databases (MEDLINE, PubMed, Google Scholar, and SPORTDiscus) was conducted to identify relevant studies.Study Selection: Studies were included if they met all of the following criteria: used a test-retest design, involved at least 1 CNT, provided sufficient statistical data to allow for effect-size calculation, and were published in English.Data Extraction: Two independent reviewers investigated each article to assess inclusion criteria. Eighteen studies involving 2674 participants were retained. Intraclass correlation coefficients were extracted to calculate effect sizes and determine overall reliability. The Fisher Z transformation adjusted for sampling error associated with averaging correlations. Moderator analyses were conducted to evaluate the effects of the length of the test-retest interval, intraclass correlation coefficient model selection, participant demographics, and study design on reliability. Heterogeneity was evaluated using the Cochran Q statistic.Data Synthesis: The proportion of acceptable outcomes was greatest for the Axon Sports CogState Test (75%) and lowest for the ImPACT (25%). Moderator analyses indicated that the type of intraclass correlation coefficient model used significantly influenced effect-size estimates, accounting for 17% of the variation in reliability.Conclusions: The Axon Sports CogState Test, which has a higher proportion of acceptable outcomes and shorter test duration relative to other CNTs, may be a reliable option; however, future studies are needed to compare the diagnostic accuracy of these instruments.

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confidence: 99%

Reliability of Computerized Neurocognitive Tests for Concussion Assessment: A Meta-Analysis

Farnsworth

Dargo

Ragan³

et al. 2017

Journal of Athletic Training

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“…The absolute difference was 2.8 points with standard deviations greater than 5.8 points). In a much larger sample, Nakayam et al (2014) noted small improvements in Impact composites across composite retest scores. Using regression-based change statistics and a 95% confidence interval ( z -score change of 1.96), no Visual Motor Speed scores improved and two declined across three test sessions.…”

Section: Introductionmentioning

confidence: 85%

“…Mixed results have been obtained with regard to repeat test administrations (for example, see Elbin, Schatz, & Covassin, 2011; Nakayama, Covassin, Schatz, Nogle, & Kovan, 2014; Register-Mihalik et al, 2012; schatz, 2010), suggesting both strong and weak inter-rater and test-retest reliabilities. Clearly, understanding the effect of repeat test administrations is an important consideration when monitoring effects of treatment or the course of recovery from injury.…”

Section: Introductionmentioning

confidence: 99%

Test–retest, retest, and retest: Growth curve models of repeat testing with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)

Maerlender

Masterson

James

et al. 2016

Journal of Clinical and Experimental Neuropsychology

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Computerized neuropsychological testing has become an important tool in the identification and management of sports-related concussions; however, the psychometric effect of repeat testing has not been studied extensively beyond test-retest statistics. The current study analyzed data from Division I collegiate athletes who completed ImPACT baseline assessments at four sequential time points that varied over the course of their athletic careers. Administrations were part of a larger NIH study. Growth curve modeling showed that the two memory composite scores increased significantly with successive administrations: change in Verbal Memory was best represented with a quadratic model, while a linear model best fit Visual Memory. Visual Motor Speed and Reaction Time composites showed no significant linear or quadratic growth. The results demonstrate the effect of repeated test administrations for memory composite scores, while speed composites were not significantly impacted by repeat testing. Acceptable test-retest reliability was demonstrated for all four composites as well.

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“…Briefly, it consists of a set of stimuli with words displayed in a single color and that form the name of another color, for instance: the word "blue" printed in green color. When the participant is asked to answer on the color of the word and ignore its identity (the word-color interference effect), the automatic processing of the word identity is inhibited due to less automated processes, such as the color used to print the word [14]. Computerized versions are considered more accurate than paper-pen versions [15].…”

Section: Primary Measurementioning

confidence: 99%

Improving Mental Performance in an Athletic Population with the Use of Ārepa®, a Blackcurrant Based Nootropic Drink: A Randomized Control Trial

Gibson

Baker

Sharples³

et al. 2020

Antioxidants

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A range of dietary bioactive ingredients have claimed to improve mental clarity and reduce fatigue, including blackcurrant, pine bark, and l-theanine. These active ingredients provide a good source of dietary polyphenols which could be useful in reducing mental fatigue in a sports setting. The aim of the investigation was to test the effect ofĀrepa ® a blackcurrant-based nootropic-drink also containing pine-bark and l-theanine (BC+), on mental clarity in a sport setting. Twenty-three rugby league players completed a cross-over design, randomized, double-blind, controlled trial. Intervention and control phases lasted 7 days, with a washout in between. Cognition was assessed pre and post intervention following a standardized training session. Our study found the total score, accuracy, and average time per response scores improved significantly more after drinking the BC+ drink (p = 0.001, 0.003, and 0.043 respectively). The BC+ improved the perception that participants were reliable (p = 0.02) and less distracted (p = 0.03), while placebo supplementation increased participant perception they could control their nervousness (p = 0.03). Thematic analysis of post-trial questionnaire indicated participants found the BC+ sour, most reported no side effects, and opinion on which drink was more effective was not unanimous. The results indicate that the BC+ drink may be useful for athletes.Antioxidants 2020, 9, 316 2 of 12 adverse physiological changes that occur in response to increased stress hormones. Stress hormones, such as cortisol, impair immune function, inhibit anabolic pathways, and promote catabolism, driving an increased risk of injury/illness, impaired ability to adapt and repair muscles, as well as increased perception of pain and fatigue [3]. Interventions that may independently reduce excess stress may indirectly assist in improving cognitive outcomes in high pressure sporting situations.With emerging evidence suggesting anthocyanin-rich blackcurrants may have a role in preventing cognitive decline [4] and enhancing physical performance [5,6], there is interest that the richly colored berries may elicit further benefits such as acute improvements in cognition. Alongside the increasing evidence for blackcurrant polyphenols, pine bark extract has also shown to improve the speed of response for the spatial working memory and immediate recognition tasks in humans [7,8], although most research has tested non-athletic, older adult participants. Nootropics are defined as substances that may improve cognitive function, particularly executive functions, memory, creativity, or motivation, in healthy individuals. For many years caffeine has been used as a successful nootropic aide, as moderate doses of caffeine can improve cognitive function, including vigilance, learning, memory, and mood state [9]. However, caffeine can become addictive, hence the search for alternative nootropic agents.A recent narrative review highlighted the physiological mechanisms behind the potential of blackcurrant polyphenols to influence co...

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Examination of the Test-Retest Reliability of a Computerized Neurocognitive Test Battery

Abstract: This study suggests that the computerized neurocognitive test battery, ImPACT, is a reliable test for postconcussion serial assessments. However, when managing concussed athletes, the ImPACT should not be used as a stand-alone measure.

Cited by 63 publications

References 30 publications

Reliability of Computerized Neurocognitive Tests for Concussion Assessment: A Meta-Analysis

Reliability of Computerized Neurocognitive Tests for Concussion Assessment: A Meta-Analysis

Test–retest, retest, and retest: Growth curve models of repeat testing with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)

Improving Mental Performance in an Athletic Population with the Use of Ārepa®, a Blackcurrant Based Nootropic Drink: A Randomized Control Trial

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