Development and Clinical Relevance of a Summary Score for the SCAT-5

Abstract

Abstract Purpose Early versions of the Sports Concussion Assessment Tool utilized a summary score, but it was removed in the third edition due to lack of empirical support (Guskiewicz et al., 2013). Echemendia et al. (2017) note that the SCAT-5’s changes, such as an expansion from a 5-word to 10-word list, improved utility over previous additions. Therefore, empirical support for a summary score on the SCAT-5 should be reassessed. Methods Collegiate athletes (N=532, 64% male) completed the SCAT-5 and ImPACT during their baseline evaluation. Various SCAT-5 summary score formulas were created to determine a concurrently valid summary score that remained comprehensive of all three SCAT-5 domains (cognitive, symptom, vestibular). The summary score was calculated by: [Immediate Memory Total + Delayed Recall + Orientation + Concentration + (30 – BESS Total Errors) - Total Symptom Score]. Results Pearson correlations determined that the summary score was significantly correlated with ImPACT Verbal Memory (r=.27, p<.001), Visual Memory (r=.24, p<.001), Visual-Motor Speed (r=.30, p<.001), Reaction Time (r=-.25, p<.001) and Total Symptoms (r=-.18, p<.001). Conclusion Our results support the validity of a SCAT-5 summary score. Clinically, the summary score is intended to measure changes in global functioning across baseline, post-trauma and follow-up concussion evaluation. Additionally, it should serve as a measure of global progression during the acute post-trauma window of sideline to post-trauma evaluation. Future research should examine the SCAT-5 summary score with outcome measures such as recovery time.