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Validity of Baseline Concussion Tests Questioned
Date:6/11/2011

SATURDAY, June 11 (HealthDay News) -- Baseline concussion tests for athletes may do more harm than good in some cases, an expert warns.

Baseline concussion testing provides a baseline score of an athlete's cognitive abilities, such as reaction time, working memory and attention span. Athletes who suffer a concussion retake the test, and if there is a large decrease in the score, they are typically banned from play until their score improves.

But the tests, which are mandatory for hundreds of thousands of amateur and professional athletes in the United States, have a high "false negative" rate, according to Christopher Randolph, a neuropsychologist at Loyola University Health System.

A false negative result means the test shows an athlete has recovered from a concussion when they're actually still experiencing effects from the injury. As a result, an athlete might be allowed to return to play before it's safe.

Randolph analyzed the scientific literature and could not find a prospective, controlled study of the current version of the most common baseline concussion test, called ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). Athletes take the 20-minute test 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 wrote in an article published in a recent issue of the journal Current Sports Medicine Reports.

Instead of relying on baseline concussion tests, medical staff on sports teams "may be better advised to rely upon their own clinical judgment, in conjunction with a validated symptom checklist, in making return-to-play decisions," for athletes who have suffered a concussion, Randolph suggested.

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