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RELIABLE CHANGE INDICES (RCI) AND TEST-RETEST RELIABILITY FOR THE CONCUSSION CLINICAL PROFILES SCREENING TOOL (CP SCREEN)

Abstract

Kori Durfee1, Philip Schatz2, Anthony P. Kontos3, Melissa N. Womble4 and R.J. Elbin1

1University of Arkansas, Fayetteville, AR

2Saint Joseph’s University, Philadelphia, PA

3University of Pittsburgh, Pittsburgh, PA

4Inova Sports Medicine Concussion Program

The Concussion Clinical Profile Screening Tool (CP Screen) is a self-report symptom inventory that characterizes Anxiety/Mood, Cognitive/Fatigue, Migraine, Ocular, and Vestibular profiles, as well as neck and sleep modifiers. The CP tool is used to screen for profile symptoms and is often administered at weekly intervals by clinicians. However, to date, reliable change indices (RCI) for clinical cutoffs and the test-retest reliability of the CP Screen across a 1-week time interval have not been established.

PURPOSE: The purpose of this study was to establish RCI cutoff scores and evaluate 1-week test-retest reliability for each profile and modifier of the CP Screen.

METHODS: Eighty-two healthy, uninjured university students (M = 20.67y, SD = 1.46; 51.2% female) completed two administrations of the CP Screen exactly 7 days apart. CP Screen items were summed into total scores for each of the five clinical profiles and two modifiers. Spearman rho coefficients (rs) and intraclass correlation coefficients (ICCs) single measures were used to assess test-retest reliability. A series of Wilcoxon signed rank tests were used to assess differences across time. RCI values with corresponding cutoff scores were provided for each clinical profile and modifiers at 95% confidence intervals (CI).

RESULTS: RCI cutoffs for clinically significant change were as follows: Anxiety/Mood>/=4; Cognitive/Fatigue, Migraine, Ocular, Vestibular, Sleep>/=3; and Neck>/=2. Only 1-5% of cases fell outside 95% CI for reliable change. Correlations ranged from .50 (Migraine) to .83 (Anxiety/Mood). ICCs ranged from .64 (Cognitive/Fatigue) to .84 (Anxiety/Mood) for all profiles indicating moderate to good reliability. Migraine, Sleep, and Neck scores were not different across time. However, Anxiety/Mood, Cognitive/Fatigue, Ocular, and Vestibular scores increased across the week.

CONCLUSIONS: CP Screen was reliable and stable across a 1-week interval, and the identified RCIs can help clinicians identify meaningful change for each profile and modifier.

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