Baseline evaluations for diagnosing concussion do not improve diagnostic accuracy

By Minhong Kim. This article was initially published in our Concussion Update newsletter; please consider subscribing.

A study by Dr. Lyndsey M. Ferris et al., published in the American Journal of Sports Medicine, analyzed the utility of baseline evaluations for identifying acute concussions in college athletes. The researchers found that using baseline evaluations does not significantly improve diagnostic accuracy. 

The authors analyzed preseason and post-injury data of three baseline evaluations—Vestibular/Ocular-Motor Screening (VOMS), Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) instrument, and the Sport Concussion Assessment Tool (SCAT3). Data consisted of 3958 preseason evaluations and 496 post-injury acute concussion evaluations of college athletes in the National Collegiate Athletic Association (NCAA).

VOMS, ImPACT, and SCAT baseline tests assess an athlete’s brain function before a sports season starts. Then, when an athlete is suspected of having sustained a concussion during the sports season, post-injury test performance can be compared to the baseline performance to help diagnose a concussion. Ferris et al. compared diagnostic accuracy when utilizing the baseline assessments versus post-injury data alone. They found that incorporating baseline scores of VOMS, SCAT3, and ImPACT did not significantly improve predictive accuracy for diagnosing concussion.

While the findings suggest that “incorporating baseline assessments does not significantly increase diagnostic yield for acute concussion,” further research may need to validate these results. The authors point to the baseline evaluation tools demonstrating “high within-patient test-retest variability, resulting in poor reliability.”