• Noah D Silverberg, Teemu M Luoto, Juha Öhman, and Grant L Iverson.
• Department of Medicine, Division of Physical Medicine & Rehabilitation, University of British Columbia , Vancouver, BC , Canada .
• Brain Inj. 2014 Jan 1;28(12):1590-3.

ObjectiveThe King-Devick Test (K-D) is a brief measure of cognitive processing speed and rapid gaze shifting that appears sensitive to the effects of sport-related concussion. This study evaluated its diagnostic and incremental validity in civilian patients with mild traumatic brain injury (MTBI).MethodsParticipants with MTBI (n = 26) and controls with non-head injuries (n = 33) were prospectively recruited from an Emergency Department (ED). They underwent a clinical evaluation including the K-D test and the Sport Concussion Assessment Tool 2 (SCAT2). Magnetic resonance imaging (MRI) was conducted within 10 days post-injury.ResultsThe patients with MTBI differed from those without MTBI on components of the SCAT2, including the Symptom Scale (Cohen's d = 1.02-1.15, p < 0.001) and Standardized Assessment of Concussion (d = 0.81, p = 0.004), but not the K-D test (d = 0.40, p = 0.148). In a logistic regression analysis, the K-D Test did not contribute over and above these two measures in predicting group membership (MTBI vs. control), p = 0.191. Low K-D Test scores in the MTBI group (<1 SD below controls) were not associated with poor SCAT2 performance, loss of consciousness or traumatic abnormalities on MRI, suggesting these cases may have been false positives.ConclusionsThe present findings do not support the K-D Test for the assessment of civilian MTBI in an ED setting.

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