Test-Retest Reliability and Reliable Change Index of Mobile Application Neurocognitive Testing Among Middle and High School Athletes

• Published in: Journal of athletic training 2024-02, Vol.59 (2), p.153-158
• Main Authors: Hashida, Kumiko, Lee, JongSoo, Furutani, Troy, Tsushima, William T., Tamura, Kaori
• Format: Article
• Language: English
• Subjects: Adolescents; Child development; Cognitive ability; Cognitive development; High Schools; Middle schools; Mobile communications networks; Secondary schools; Student athletes
• ISSN: 1062-6050; 1938-162X
• DOI: 10.4085/1062-6050-0018.23

ContextA mobile application neurocognitive assessment has been used in place of equipment-intensive computerized neurocognitive-assessment protocols. A previous study showed high to very high test-retest reliability of neurocognitive assessment using the mobile application in healthy adults, but no researchers have explored test-retest reliability, reliable change indices (RCIs), and sex effects in middle school and high school populations when conducted 1 year apart.ObjectivesTo examine the test-retest reliability and RCIs of baseline data collected at 2 time points approximately 1 year apart using a mobile application neurocognitive test in middle school and high school athletes. The secondary purpose was to investigate sex differences in neurocognitive measures.DesignCross-sectional study.SettingInstitution.Patients or Other ParticipantsA total of 172 middle school and high school healthy student-athletes (mean age = 13.78 ± 1.59 years).Main Outcome Measure(s)Mobile application neurocognitive test scores (reaction time, impulse control, inspection, and memory).ResultsNeurocognitive measures had low test-retest reliability across a 1-year time period in the middle and high school settings. Upon retesting, reaction time and inspection time improved in both middle and high school athletes, and impulse control improved in middle school athletes. More athletes in middle school showed RCI improvements compared with high school athletes. Although both males and females demonstrated improvements in neurocognitive measures throughout adolescence, males outperformed females in reaction time and impulse control.ConclusionsA mobile application neurocognitive test displayed unacceptably low test-retest reliability, most likely due to the cognitive development occurring throughout adolescence. Additionally, significant RCIs were noted. These naturally occurring improvements due to cognitive development could mask postconcussion deficits. Age and sex warrant consideration with respect to the neurocognitive performance of middle and high school athletes.