by Matt Holcomb, PhD
The present study is a cohort comparison study which evaluated possible difference in performance between high school athletes completing preseason baseline neurocognitive testing in group versus individualized settings. Findings, suggest that baselines obtained in group settings showed decreased performance when compared to those tested individually. Far from condemning the practice of group neurocognitive testing, the purpose of the article is to educate and highlight limitations of group administration on neurocognitive testing; thus minimizing its impact on performance. Limitations include a lack of effort testing, retrospective group assignment, and unstandardized instructions (particularly for participants assigned to the “group” condition). There is also no control for team-effects (most football players received individual administration, while soccer players received group administration). Read more
The article titled, “Differences in Change Scores and the Predictive Validity of Three Commonly Used Measures Following Concussion in the Middle School and High School Aged Population, by M. Barlow et al, 2011, is a level B study that utilizes a cohort comparison design. The title, abstract, and background information are generally effective in providing appropriate information and understanding. However, the study has a number of methodological concerns related to the sample characteristics, assessment tools, and statistical procedures that were used. The limitations of this study are serious enough to call into question the results and proposed implications.
By Erin Almklov, PhD
Citation: Yard, E. E., & Comstock, R. D. (2011). Compliance with return to play guidelines following concussion in US high school athletes, 2005-2008. Brain Injury, 23(11), 888-898.
Review by Laszlo A. Erdodi, PhD
This was a prospective cohort study including 100 nationally representative American high schools. Concussion data were provided by certified athletic trainers through an online reporting system. Injuries were retrospectively graded according to AAN and Prague return-to-play (RTP) guidelines. The strengths of the study are a large, demographically representative sample; simultaneous comparison of concussion rates based on AAN and Prague classification; reporting data separately for gender, concussion severity and type of sport. Some of the weaknesses are selection bias (inclusion criteria favor better regulated institutions); imperfection in reporting system (insufficient detail to confidently classify a given incident); and concussion severity classification was performed post hoc.