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Diagnosing Concussions: How Accurate Is Tablet-Based Software ‘BrainCheck’?

Every year in the U.S., between 1.2 and 2.85 million people sustain a concussion, a mild form of traumatic brain injury (TBI). These injuries cause irreversible neurological issues in at least 70,000 of these concussion sufferers, costing about $60 billion annually.

While these statistics may be compelling enough, researchers and medical professionals believe they underestimate the actual number of mild TBI cases occurring each year in the U.S. (due to some not seeking treatment, as well as a lack of a central database to track these cases).

These factors have triggered a “call to action to provide more objective measures of cognitive functioning” for concussion patients. Responding to this call, researchers recently conducted a study on tablet-based diagnostic software for concussions, known as BrainCheck. The goal was to determine the “diagnostic accuracy of BrainCheck when compared to physician diagnoses of concussion.”

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Concussion Diagnostic Study: The Details

Diagnosing Concussions: How Accurate Is BrainCheck Software?

Diagnosing Concussions: How Accurate Is BrainCheck Software?

Entitled Diagnostic accuracy of tablet-based software for the detection of concussion, the study included 598 participants between the ages of 18 and 64. These participants included:

  • A concussed group, which included participants who had presented to an emergency room with a brain injury and who had a Glasgow Coma score (GCS) of 14 or 15
  • A pain-matched control group, which included participants defined as those “clinically determined to be experiencing similar amounts of pain but without any head injury (e.g., someone with a sprained ankle)
  • A group of healthy individuals, who were selected from 10 different “control test sites.”

After signing consent forms, each group was provided with BrainCheck, a battery of six tablet-based neurocognitive tests, including:

  1. The Flanker Task to assess reaction times
  2. The Digit Symbol Substitution Task to measure general cognitive performance
  3. The Stroop Task to evaluate reaction time for overcoming “cognitive interference”
  4. The Trail Making Test to assess visual attention and task switching
  5. The Balance & Coordination Test to detect any subtle problems with balance and/or coordination
  6. The Immediate & Delayed Recall Test to evaluate memory.

Most participants reportedly completed BrainCheck within five minutes.

The Findings & Conclusions

After analyzing participants’ responses, researchers found that:

  • BrainCheck was able to accurately distinguish concussed individuals from both the pain-matched group and the healthy group.
  • Performance on the test varied by age, with participants between 19 and 51 displaying “peak performance.”
  • “There were no performance differences by sex,” except for some “small performance advantages for males on the coordination test and for females on the Trail Making Test.”

Based on their analysis and findings, researchers concluded that BrainCheck “provided a sensitive and specific test for TBI with sensitivity and specificity of 83% and 87%, respectively.” Additionally, they reported that:

Because this test can be performed rapidly, with no expertise to administer, and has safeguards to preclude malingering, it may be a candidate for use by military and athletics teams to rapidly make fitness-for-duty or return-to-play decisions.

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