1. Sensitivity and Specificity of the ImPACT Neurocognitive Test in Collegiate Athletes and US Military Service Academy Cadets with ADHD and/or LD: Findings from the NCAA-DoD CARE Consortium.
- Author
-
Czerniak, Lauren L., Liebel, Spencer W., Zhou, Hannah, Garcia, Gian-Gabriel P., Lavieri, Mariel S., McCrea, Michael A., McAllister, Thomas W., Pasquina, Paul F., Broglio, Steven P., CARE Consortium Investigators, Benjamin, Holly J., Brooks, Alison, Buckley, Thomas, Cameron, Kenneth L., Clugston, James R., Duma, Stefan M., Eckner, James T., Estevez, Carlos, Feigenbaum, Luis A., and Giza, Christopher C.
- Subjects
- *
BRAIN concussion diagnosis , *DECISION trees , *PREDICTIVE tests , *MACHINE learning , *RANDOM forest algorithms , *MANN Whitney U Test , *NEUROPSYCHOLOGICAL tests , *ATTENTION-deficit hyperactivity disorder , *LEARNING disabilities , *DESCRIPTIVE statistics , *CHI-squared test , *RESEARCH funding , *SENSITIVITY & specificity (Statistics) , *LOGISTIC regression analysis , *DATA analysis software , *RECEIVER operating characteristic curves , *MILITARY personnel , *SECONDARY analysis - Abstract
Background and Objective: Computer-based neurocognitive tests are widely used in sport-related concussion management, but the performance of these tests is not well understood in the participant population with attention-deficit/hyperactivity disorder (ADHD) and/or learning disorder (LD). This research estimates the sensitivity and specificity performance of the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) computer-based neurocognitive test in identifying concussion in this population. Methods: Study participants consisted of collegiate university athletes and military service academy cadets from the National Collegiate Athletic Association-Department of Defense CARE Consortium who completed the ImPACT test between 2014 and 2021. Participants who self-identified as belonging to one of the subgroups of interest (ADHD with or without LD [ADHD:LD+/−], LD with or without ADHD [LD:ADHD+/−], ADHD and/or LD [ADHD a/o LD]) and completed a baseline (1874 ADHD:LD+/−, 779 LD:ADHD+/−, 2338 ADHD a/o LD) or 24–48 h post-concussion (175 ADHD:LD+/−, 77 LD:ADHD+/−, 216 ADHD a/o LD) ImPACT assessment were included. Sensitivity and specificity were calculated using a normative data method and three machine learning classification methods: logistic regression, classification and regression tree, and random forest. Results: Using the four methods, participants with ADHD:LD+/− had sensitivities that ranged from 0.474 to 0.697, and specificities that ranged from 0.538 to 0.686. Participants with LD:ADHD+/− had sensitivities that ranged from 0.455 to 0.688, and specificities that ranged from 0.456 to 0.588. For participants with ADHD a/o LD, sensitivities ranged from 0.542 to 0.755, and specificities ranged from 0.451 to 0.724. Conclusions: For all subgroups and analytical methods, the results illustrate sensitivity and specificity values below typically accepted levels indicative of clinical utility. These findings support that using ImPACT alone may be insufficient to inform concussion diagnoses and encourages the use of a multi-dimensional concussion assessment. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF