King-Devick Test a Reliable Sideline Assessment of Concussion
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Early detection of concussion is key to preventing further brain injury, but access to care isn't always easy on the sidelines. A review of studies focused on concussion detection, however, have confirmed that use of a simple vision test, in conjunction with other rapid concussion assessments, results in 100% concussion detection.
The study, published in Concussion, affirms the viability of the King-Devick test in rapid concussion detection scenarios, where access to a medical professional may be limited.
“The test is no substitute for a diagnosis from an experienced medical provider, but this test enables parents, coaches, trainers, and providers on sidelines to have a protocol where they can stop and decide whether an athlete should be removed from play and sent to follow-up care,” Steven Galetta, MD, chair of neurology at NYU Langone Medical Center, and Laura Balcer, MD, MSCE, co-director of the NYU Langone Concussion Center, told Neurology Advisor.
For the study, Balcer and colleagues reviewed 15 studies in which a rapid number naming test -- where participants read numbers on cards from left to right as quickly as possible, then times for all three reading cards are recorded and added together and compared with a baseline score -- was administered. In total, the review included 1,419 athletes, 112 of whom sustained a concussion.
On average, concussed athletes took 4.8 seconds longer to complete the King-Devick test compared to their baseline scores, whereas non-concussed athletes improved their score by an average of 1.9 seconds.
“Our meta-analysis found that if an athlete had a worsening in their time compared to their baseline reading, they were five times more likely to have sustained a concussion,” Balcer said. “The King-Devick test showed a sensitivity of 86% and specificity of 90% in over 100 patients that had concussion and were formally tested on the sidelines.”
Other concussion assessments, including the SCAT3 symptom checklist and timed tandem gait test, were used in some studies included in the review. The researchers pointed out that a worsening in score in at least one of the three tests, including the King-Devick, was observed in 100% of concussed athletes.
“Early concussion detection during a sporting event is essential in order to ensure an athlete is not being put at added risk by remaining in the game and sustaining another concussion or injury,” Balcer and Galetta told Neurology Advisor. “This tool, as part of a simple battery of tests assessing cognition and balance, can raise a flag for those athletes that require follow-up with a medical professional,” Galetta added.
Disclosure: Study co-author Danielle Leong, MD, is an employee of King-Devick Test, LLC.
- Galetta KM et al. Concussion. 2015; doi:10.2217/cnc.15.8.