Group brain tests of athletes not as accurate

NEW YORK (Reuters Health) - Testing young athletes' thinking and memory skills in group settings, as is typically done before every season, may be less accurate than doing the tests individually, a new study finds.

Such tests are important because when athletes get head injuries, doctors often compare post-injury scores with preseason ones to see when they are recovered and ready to return to play.

Letting them back on the field too soon puts them at risk for "second impact syndrome," a rare but dangerous condition that happens when a second head injury occurs before the first one has healed.

High schools that use the tests generally give them to athletes in groups at the start of the season, partly because that's a lot cheaper and quicker than administering them to each athlete individually.

In the new study, Summer Ott of the Methodist Hospital Concussion Center in Houston and her colleagues compared scores from high schoolers who took one type of computer-based test individually with students who took it in a school computer lab with up to 19 teammates.

That test measures athletes' attention and memory skills, as well as processing speed and reaction time. On all of those scales, the 164 teens who took the test in groups scored lower than the 167 who did it without any distracting peers.

The findings add to other studies challenging the brain tests' accuracy. According to Paul Comper, a concussion expert at the University of Toronto, they show that doctors and trainers need to use their own judgment -- and not just a number -- to decide when injured athletes are back to normal.

"It's not as simple as a young athlete taking a 25-minute test and then they get a concussion and then somebody can look at a score and they get a red light or a green light," Comper, who was not involved in the new research, told Reuters Health.

That doesn't mean the tests aren't useful, Comper and Ott agreed. But the more accurate an initial, pre-injury score is, the more a later score can tell doctors about an injured brain.

How focused athletes are while taking the test, as well as their mood and stress levels, affects scores of how well the brain is working, Comper said.

He pointed out that when the tests are done after an injury, it's never in a group setting. If athletes were distracted while taking their initial tests, doctors might not notice when post-concussion scores are lower than they should be.

Still, group testing shouldn't be done away with, Ott warned, because any pre-injury scores are better than none -- and individual testing isn't always feasible.

She and her colleagues suggest in The American Journal of Sports Medicine that schools should try to make group testing rooms as quiet and distraction-free as possible, space athletes apart at computers and make sure they're not tired when they're taking the tests. That means no testing after two-a-day practices, she said.

Comper said it's important that doctors consider any lingering symptoms and use their clinical judgment when interpreting post-injury tests and deciding whether athletes are ready to play again, regardless of how baseline testing was done.

Still, he said, "These tests are valuable, there's no doubt about it. We shouldn't lose that message."

SOURCE: http://bit.ly/nLihTu The American Journal of Sports Medicine, online August 9, 2011.

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