A Cohort Study of the Temporal Stability of ImPACT Scores Among NCAA Division I Collegiate Athletes: Clinical Implications of Test-Retest Reliability for Enhancing Student Athlete Safety.
A Cohort Study of the Temporal Stability of ImPACT Scores Among NCAA Division I Collegiate Athletes: Clinical Implications of Test-Retest Reliability for Enhancing Student Athlete Safety.
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NCAA I 级大学运动员 ImPACT 分数时间稳定性的队列研究：重测可靠性对增强学生运动员安全的临床意义。
DOI：
10.1093/arclin/acaa047
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Gorgens,KimA
中科院分区：
文献类型：
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作者：
Mason,SaraJ;Davidson,BradleyS;Lehto,Marybeth;Ledreux,Aurélie;Granholm,Ann-Charlotte;Gorgens,KimA
目的在本研究中，我们使用一系列详尽的统计模型，考察了NCAA一级运动员在不同时间点的脑震荡后立即评估和认知测试（ImPACT）的时间稳定性。方法在队列设计中，48名运动员在不同的时间点完成了重复的基线影响评估。采用绝对一致的双向混合效应模型计算类内相关系数（ICC）。结果四个ImPACT综合得分（言语记忆、视觉记忆、视觉运动速度和反应时间）在典型的一级运动员职业生涯中表现出中等信度（ICC = 0.51-0.66），低于先前用于个人决策的措施的信度建议（0.90）。在言语记忆、视觉运动速度或反应时间综合评分中没有发现固定偏差的证据，最小可检测的变化值超过了一致性的限制。结论：ImPACT的时间稳定性低于已发表的建议，因此，不能为NCAA的建议提供强有力的支持，即在运动员的整个职业生涯中获得单一的参与前认知基线，用于与运动相关的脑震荡管理。临床解释指南提供给临床医生谁利用基线影响评分为以后的性能比较。
ObjectiveIn this study we examined the temporal stability of the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) within NCAA Division I athletes across various timepoints using an exhaustive series of statistical models.MethodsWithin a cohort design, 48 athletes completed repeated baseline ImPACT assessments at various timepoints. Intraclass correlation coefficients (ICC) were calculated using a two-way mixed effects model with absolute agreement.ResultsFour ImPACT composite scores (Verbal Memory, Visual Memory, Visual Motor Speed, and Reaction Time) demonstrated moderate reliability (ICC = 0.51–0.66) across the span of a typical Division I athlete’s career, which is below previous reliability recommendations (0.90) for measures used in individual decision-making. No evidence of fixed bias was detected within Verbal Memory, Visual Motor Speed, or Reaction Time composite scores, and minimal detectable change values exceeded the limits of agreement.ConclusionsThe demonstrated temporal stability of the ImPACT falls below the published recommendations, and as such, fails to provide robust support for the NCAA’s recommendation to obtain a single preparticipation cognitive baseline for use in sports-related concussion management throughout an athlete’s career. Clinical interpretation guidelines are provided for clinicians who utilize baseline ImPACT scores for later performance comparisons.