Thanks to an alert reader an article was sent to the inbox dealing with neuropsychological testing, specifically the ImPACT test. The author of the article published on Slate, Christine Aschwanden, provides a very well written reason as to why some are starting to take a much harder look on these types of tests;
On closer inspection, though, the whole thing begins to fall apart. “It’s a huge scam,” says physician Robert Sallis, past president of the American College of Sports Medicine. “They’ve done incredible marketing, and they’ve managed to establish this test as the standard of care with no evidence that it has any benefit.”
Dr. Sallis is not the only one, in fact we receive numerous questions about all the NP tests, and recently we have seen more and more research regarding the downfalls of this type of testing. Research like this one (sourced in the article) written by physical therapists and a physician are being done by independent parties and seem to reveal there is a problem. According to one of the developers of ImPACT some of the information is not viable if only because of the particular journal it appeared in;
All that aside, if you’re to trust the numbers, the ImPACT test would need to produce the same scores on a given kid each time he or she takes it in an unimpaired state. That doesn’t always happen. In one independent study, 118 healthy student volunteers took a baseline ImPACT test and then returned to retake the test twice more, 45 and 50 days later. In the follow-ups, more than one-third of the concussion-free participants showed up as false positives, which made it seem as if they really had the symptoms of a concussion and were maybe lying about the symptoms. Lovell points to the fact that this study was published in the second-tier Journal of Athletic Training, rather than a more respected neurology journal.
If the reporting is accurate, Lovell basically slams the people who are most often the ones having to deal with this instrument in the concussion “tool box”. Not only that, the elitist attitude that only “real research” is published in respected neurology journals. Sound research is repeatable, and all indications have shown that even the JoAT wouldn’t put trash in their journal, in fact a lot of the original research on concussions were found in JoAT. Wait there is more…
In 2008 research authored by none other than Lovell was published in Journal of Athletic Training. But wait there is more…
If you just simply “Google Scholar” Lovell+Journal of Athletic Training you will find that there are many hits, but this can be expected because of their target audience in the concussion battle, athletic trainers. What is more, there are MANY of his published articles that cite other research from the JoAT. Seems odd that he would slam the JoAT all the while using work from the journal and even publishing articles in it.
OK, my diatribe on the JoAT and Lovell’s apparent slight is over, back to the issue at hand.
ImPACT and others have an issue with testing reliability, it should be buyer beware. What really needs to happen is to have access to athletic trainers when there is problem surfacing about concussions. These properly trained individuals are the first line of defense, issuing a computer based test to “protect” you in case of problems will only go so far.
FWIW, I agree with the article about how ImPACT specifically has capitalized on the great marketing of their product. I also believe that tests like this are important to the whole picture and as they and other NP test advertise they should not be used solely for return to play decisions. However if money is an issue, the free SCAT2 is always an option for a baseline and follow-up tests.