The efficiency of the King-Devick Test for detecting concussion in a youth athlete population

Abstract

Objective1) To investigate the efficiency of the King-Devick Test (KDT) as a screening tool for concussion in a pediatric collision-sport population prone to concussion 2) to examine the accuracy of the KDT when administered by trained laypersons.BackgroundThe KDT is an efficient sideline assessment tool for sport-related concussion (Howitt et al., 2016). KDT has been shown to be sensitive to the effects of concussion, reliable, and easy to use and interpret (Echemendia et al. 2017). There are rarely medical professionals on the sideline of youth events and the KDT has effectively been administered by laypersons in a cohort of amateur boxers (Leong, et al., 2013).Design/Methods32 sideline KDT evaluations (21 possible concussions; 11 controls; 3 excluded due to inability to confirm concussion diagnosis) of 28 collision sport athletes (1 female) aged 7 to 15 were conducted. Sideline KDT time was compared to baseline KDT time to determine pass or fail (>1 second longer = fail). Sensitivity and specificity for KDT were calculated to determine KDT ability to identify concussion. Medical professional identification of concussion = concussion diagnosis. 10 concussions were identified. Further analysis evaluated sensitivity and specificity of KDT based on who conducted sideline evaluation (layperson n = 10).ResultsThe overall sensitivity was 80% and specificity was 89.5%. When administered by a layperson, sensitivity was 100% and specificity was 80.0%.ConclusionsIn this small study, KDT was helpful for detecting the presence of concussion and correctly identifying individuals without concussion. KDT should be added to sideline concussion screening in a pediatric population prone to concussion. Ideally, medical professionals should be present; however, when administered by laypersons, the KDT yielded excellent sensitivity and adequately identified those without concussion supporting its effective administration by trained laypersons as a practical screening tool.