Performance Validity Testing in Patients Presenting to a Specialty Clinic With a Mild Traumatic Brain Injury

Objective: To evaluate predictors of performance validity testing (PVT) and clinical outcome in patients presenting to a specialty clinic with a mild traumatic brain injury (mTBI). Setting: An outpatient mTBI specialty clinic. Participants: Seventy-six (47% female) patients aged 16 to 66 (mean = 40.58, SD = 14.18) years within 3 to 433 days (mean = 30.63, SD = 54.88, median = 17.00) of a suspected mTBI between 2018 and 2019. Design: A cross-sectional, observational study comparing patients who passed PVT (n = 43) with those who failed (n = 33). A logistic regression (LR) was conducted to evaluate factors that predicted failed PVT. Independent-samples t tests and general linear model were used to evaluate PVT groups on clinical outcomes. The LR with a receiver operating characteristic (ROC) curve was conducted to evaluate embedded validity indicators. Main Measures: Performance validity testing, computerized neurocognitive testing, vestibular/oculomotor screening, symptom reports. Results: At their initial clinic visit 43% of patients failed PVT. PVT failure was predicted by presence of secondary gain (odds ratio [OR] = 8.11, P = .02), while a history of mental health predicted passing of PVT (OR = 0.29, P = .08). Those who failed PVT performed significantly worse on computerized neurocognitive testing (P
Source: The Journal of Head Trauma Rehabilitation - Category: Neurology Tags: Focus on Clinical Research and Practice Source Type: research