Criterion validity of the brief test of adult cognition by telephone (BTACT) for mild traumatic brain injury

ABSTRACT

Objectives

There is a growing demand for remote assessment options for measuring cognition after mild traumatic brain injury (mTBI). The current study evaluated the criterion validity of the Brief Test of Adult Cognition by Telephone (BTACT) in distinguishing between adults with mTBI and trauma controls (TC) who sustained injuries not involving the head or neck.

Methods

The BTACT was administered to the mTBI (n = 46) and TC (n = 35) groups at 1–2 weeks post-injury. Participants also completed the Rivermead Post Concussion Symptoms Questionnaire.

Results

The BTACT global composite score did not significantly differ between the groups (t(79) = −1.04, p = 0.30); the effect size was small (d = 0.23). In receiver operating characteristic curve analyses, the BTACT demonstrated poor accuracy in differentiating between the groups (AUC = 0.567, SE = 0.065, 95% CI [0.44, 0.69]). The BTACT’s ability to discriminate between mTBI and TCs did not improve after excluding mTBI participants (n = 15) who denied ongoing cognitive symptoms (AUC = 0.567, SE = 0.072, 95% CI [0.43, 0.71]).

Conclusions

The BTACT may lack sensitivity to subacute cognitive impairment attributable to mTBI (i.e., not explained by bodily pain, post-traumatic stress, and other nonspecific effects of injury).

KEYWORDS:

• Craniocerebral trauma
• traumatic brain injury
• concussion
• cognition
• neuropsychological tests
• telemedicine

Disclosure statement

No potential conflict of interest was reported by the author(s).

Declarations of Interest

WJP reports personal fees from Abbatis Bioceuticals, Medipure Pharmaceuticals and is owner of Translational Life Sciences. All of these companies are early-stage biotechnology enterprises with no relation to brain injury; IJT reported serving as a consultant for Community Living British Columbia; NDS received research salary support from the Michael Smith Foundation for Health Research. He has an independent practice in forensic neuropsychology; KOY acknowledges support from the Ronald and Irene Ward Chair in Pediatric Brain Injury, which is funded by the Alberta Children’s Hospital Foundation. The remaining authors have no potential competing interests to report.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02699052.2022.2109744

Additional information

Funding

Brain Canada (PSG14-3457), Genome British Columbia, Hospital for Sick Children, Djavad Mowafaghian Centre for Brain Health, SickKids Centre for Brain aand Mental Health, Child & Women’s Health Centre of BC, Providence Health Care Society, Canadian Institutes of Health Research: Institute of Neuroscience Mental Health and Addiciton, SickKids Research Institute and University of British Columbia.