Recently a single article was published in one paper and then later picked up by USA Today. So of course we were interested in this. Being believers in the use of Neuro-Cognitive Baseline test as a vital and mandatory tool in the overall battle to stem concussion and TBI in youth sports we obviously are interested in anyone who has a valid point against their use.
In a recent write up by Doctor Christopher Randolph of Loyola University he questions the validity of such tests and is most concerned about false negative reports.
The tests, which are mandatory for hundreds of thousands of amateur and professional athletes in the United States, have a high “false negative” rate, according to Christopher Randolph, a neuropsychologist at Loyola University Health System.
A false negative result means the test shows an athlete has recovered from a concussion when they’re actually still experiencing effects from the injury. As a result, an athlete might be allowed to return to play before it’s safe.
“”There is no evidence to suggest that the use of baseline testing alters any risk from sport-related concussion, nor is there even a good rationale as to how such tests might influence outcome,” Randolph wrote in an article published in a recent issue of the journal Current Sports Medicine Reports.
Now Randall does not himself seem to back up his claims of a high false negative rate. It certainly does not appear that he himself has any data or information specific to that claim.
The other thing Randall says is, “Instead of relying on baseline concussion tests, medical staff on sports teams may be better advised to rely upon their own clinical judgment, in conjunction with a validated symptom checklist, in making return-to-play decisions.”
Now why does he assume that a medical professional would use baseline testing as a play or no play test? Does he really think that any doctor in his right mind would do this? To do so would be against everything that has been written, breach all current standards of care, and leave said doctor liable to civil and potentially criminal charges.
ImPACT is clear in the use of their tool. It is just that. A tool. And only Doctors specifically certified and trained in the use of that tool are recommended or should be allowed to make a decision in it’s use as such.
What is Randall really saying? Is he saying the way we have been doing things all these years… the same methods that have led to CTE and dozens of deaths and tens of thousands of long term impairments from sport related Brain Trauma …. is he saying that is better?
Because we serve those who have been killed or severely injured by TBI and concussion we find his arguments weak and counter productive to a resolution to the Concussion Crisis.
His voice is a loan one in the medical community for the most part.
What we are going to ask is this? Why is he the only one we have read to have a written such a critical view? His biography shows that he has an extensive background in this area but that none of it is specific to athletes and severe head trauma. And what about this?
“He (Randolph) has also been a leader in neurocognitive test development, working as a scientific consultant on the revisions of the most widely-used measures of intelligence and memory in the world for The Psychological Corporation. Dr. Randolph is also the author of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS™).
The RBANS is a brief (25’) neurocognitive battery with alternate forms that has undergone North American standardization/norming, with subsequent translations into multiple languages and extensive clinical validation through peer-reviewed publication. It is the most commonly-used neurocognitive battery for the evaluation of dementia in North America, and has been increasingly implemented in clinical trials and clinical evaluations in Europe, Asia, and Latin America. Dr. Randolph is extensively-published, including peer-reviewed publications on studies of Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, vascular dementia, Tourette’s syndrome, traumatic brain injury, epilepsy, schizophrenia, and affective disorders.”
Hmmm…….. why would a Doctor who is the creator of one Neuro-Cognitive test write a critical review of other providers including the most widely used competing product; ImPACT? Provocative question no doubt.
Well we may never know and he has his opinions and is certainly welcome to them. Perhaps he has a better product that he wants to bring to fray being the developer of “the most commonly-used neurocognitive battery for the evaluation of dementia in North America.”
Source for these quotes is right here: http://www.kappaclinical.com/about.html
We disagree 100% with his position. ImPACT is a valuable tool in the battle to save our kids. Period.
It’s use is crucial but will and can never replace the decision making of a highly trained medical professional who has the latest protocols on concussion and TBI in their training.