App-based assessment tool may be useful for rapid sideline concussion diagnosis

CHICAGO – An app-based cognitive assessment tool set baseline scores for college football players and may be useful in rapid sideline concussion diagnosis, according to a poster at the 2022 American Neurological Association meeting.

“There is a major deficit in our ability to diagnose concussions on the sideline,” Scott N. Grossman, MD, of the department of neurology, New York University Grossman School of Medicine, told Healio. “The current standard is a number of different approaches, including tests of balance, vestibular or ocular dysfunction. But none of those actually require the patient to say how they are symptomatically compared to their baseline.”

Grossman and colleagues sought to address this diagnosis gap by developing an app called the Mobile Integrated Cognitive Kit (MICK) to deliver a series of Rapid Automatized Naming tasks, as well as those of the Mobile Universal Lexicon Evaluation System (MULES) and Staggered Uneven Number (SUN) tests, which aim to provide immediate concussion diagnosis through player response under game conditions. Prior studies had assessed player responses only in an office setting.

Researchers partnered with the coaching staff of the Michigan State Spartans to assess the feasibility of MICK administration on preseason baseline testing within an athletic training environment. Eighty-two players underwent baseline testing with MICK, were given the digital versions of MULES and SUN tasks on Android tablets and were asked to name each of the pictures in MULES as well as the numbers in SUN as quickly as possible. Screens were advanced by tapping them, and a voice recording of each trial was captured for each player. Players were asked to complete two trials with each test.

Results showed the average MULES times were 55.3 ± 12.8 seconds in the first trial, and 43 ± 9.16 seconds in the second trial, with the average for the better of the two at 42.9 ± 9 seconds. Average SUN test times were 59.4 ± 10.5 seconds in the first trial and 56.1 ± 9.9 seconds in the second trial, with the average best at 55.5 ± 9.9 seconds.

Both MULES and SUN average test times in the training cohort compared favorably with those in the pilot study with the office cohort (38.6 ± 7.3 seconds and 45.2 ± 8.3 seconds, respectively).

“The data we’re presenting demonstrate that when we give these tasks via a tablet app to Division I football players, they’re able to reliably take it [and develop] a preseason baseline and respond to game-time conditions,” Grossman said.