Krause David A, Hollman John H, Breuer Logan T, Stuart Michael J
Mayo Clinic Program in Physical Therapy, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota.
Clin J Sport Med. 2022 May 1;32(3):e313-e315. doi: 10.1097/JSM.0000000000000938. Epub 2021 May 7.
To compare the validity indices of the King-Devick (KD) test in hockey players using any increase in test time over baseline to a 6-second increase as a positive concussion test. We hypothesized the KD test using the 6-second change would yield greater validity indices.
Prospective observational cohort study.
Sports complex.
Sixty-five male hockey players aged 13 to 20 years.
Concussion diagnosis.
Time to complete the KD test. Sensitivity (SN), specificity (SP), and the positive likelihood ratios (LRs+) were calculated using 2 thresholds for a positive test: (1) any increase in time and (2) an increase of 6 seconds or greater.
Eighteen players (27.7%) were diagnosed with a concussion. Using any increase in time as a positive test yielded the following: SN 72.2%, SP 78.7%, LR+ 3.4, and LR- 0.4. Using the 6-second threshold yielded the following: SN 44.4%, SP 93.6%, LR+ 7.0, and LR- 0.6. A receiver operator curve analysis confirmed 6.40 seconds or greater maximized the LR+.
A 6-second or greater increase in the KD test performance provides greater validity in diagnosing concussion as compared with any increase in performance time.
比较在曲棍球运动员中使用国王-德维克（KD）测试的有效性指标，将测试时间相对于基线的任何增加与增加6秒作为阳性脑震荡测试进行比较。我们假设使用6秒变化的KD测试将产生更高的有效性指标。
前瞻性观察队列研究。
体育综合设施。
65名年龄在13至20岁之间的男性曲棍球运动员。
脑震荡诊断。
完成KD测试的时间。使用阳性测试的两个阈值计算敏感性（SN）、特异性（SP）和阳性似然比（LR+）：（1）时间的任何增加和（2）增加6秒或更多。
18名运动员（27.7%）被诊断为脑震荡。将时间的任何增加作为阳性测试得出以下结果：SN 72.2%，SP 78.7%，LR+ 3.4，LR- 0.4。使用6秒阈值得出以下结果：SN 44.4%，SP 93.6%，LR+ 7.0，LR- 0.6。受试者工作特征曲线分析证实，6.40秒或更长时间可使LR+最大化。
与测试时间的任何增加相比，KD测试表现增加6秒或更多在诊断脑震荡方面具有更高的有效性。
