Journal of the International Neuropsychological Society

Sensitivity and specificity of standardized neurocognitive testing immediately following sports concussion

a1 Departments of Neurology and Psychiatry, New York University Medical Center, New York, NY
a2 Neuropsychology Service, Waukesha Memorial Hospital, Waukesha, WI
a3 Department of Neurology, Medical College of Wisconsin, Milwaukee, WI


Neuropsychology, with its emphasis on standardized and empirically based methods, has made a number of scientific contributions to address growing concerns about concussions resulting from sports injuries. This study employs a test–retest paradigm to determine the immediate effects of concussion in high-school and college athletes. The Standardized Assessment of Concussion (SAC) was administered to 1,313 male athletes prior to the beginning of the competitive season. Reliable change indices and multiple regression models were computed on retest scores obtained from 68 noninjured athletes who were readministered the SAC at either 60 or 120 days following baseline testing. Receiver operating characteristic (ROC) curve analyses were used to test these models with data obtained on 50 athletes tested immediately following concussion. The results indicate that a decline of 1 point on the SAC at retesting classified injured and noninjured participants with a level of 94% sensitivity and 76% specificity. The RCI and multiple regression models provided comparable levels of group classification, but provided cut-offs that are conservative for use with this population. The results support and extend previous research findings indicating that the SAC is a valid instrument for detecting the immediate effects of mild traumatic brain injury. (JINS, 2001, 7, 693–702.)

(Received April 4 2000)
(Revised August 25 2000)
(Accepted August 29 2000)

Key Words: Sports injuries; Concussion; Test–retest reliability; Traumatic brain injury.

c1 Reprint requests to: William B. Barr, Ph.D., NYU Comprehensive Epilepsy Center, 560 First Avenue, Rivergate 4th Floor, New York, NY 10016. E-mail: