Acute Assessment of Mild Traumatic Brain Injury with the King-Devick Test in an Emergency Department Sample Objectives Results The MTBI and trauma control were well-matched on age and education, but the former contained a somewhat higher proportion of males (73% vs 52% ; chi2=3.71, p=.054). Group differences on the clinical tests are presented in the Table. In summary: Post Concussion Symptom Scale: Yes SAC: Yes The K-D test: No In logistic regression with group membership (MTBI vs. trauma control) as the dichotomous outcome: Entering SAC and Symptom Score as predictors achieved good discrimination (chi2=19.2, p<0.001, Nagelkerke R2=0.398, area under the Receiver Operating Characteristic Curve=0.827). Adding the K-D test did not contribute incrementally (p=0.191). Low K-D scores in the MTBI group (<1 standard deviation below trauma controls) were not associated with loss of consciousness or traumatic abnormalities on magnetic resonance imaging, suggesting that these cases may have been false positives. The King-Devick Test (K-D) is a brief measure of cognitive processing speed and rapid gaze shifting that appears sensitive to the acute effects of sport-related concussion. The present study aimed to evaluate its diagnostic and incremental validity in civilian trauma patients with mild traumatic brain injury (MTBI). Methods Participants: patients with MTBI, n=26, and trauma controls with non-head injuries, n=33. Emergency Department of Tampere University Hospital. World Health Organization’s MTBI criteria were applied. Nine exclusion criteria were used to rule out pre-existing medical conditions or other confounding factors. The patients and controls underwent a clinical evaluation that included: the K-D test and previously validated assessment tools for MTBI that are part of the Sport Concussion Assessment Tool (editions 2 & 3): the Post Concussion Symptom Scale, and the Standardized Assessment of Concussion (SAC). The patients with MTBI were assessed at an average of 31 hours post-injury (range=4-72h). Magnetic resonance imaging (3 Tesla) was also conducted within 10 days hospital discharge. Table. Descriptive statistics and mean comparisons for the King-Devick Test® and Sport Concussion Assessment Tool components.   Mean (SD) MTBI Controls F p Cohen’s d K-D Test Trial 1 58.86 (16.21) 52.70 (11.95) 2.64 0.110 0.43 K-D Test Trial 2 51.68 (12.09) 47.15 (10.06) 2.28 0.137 0.41 Best K-D Test Score 51.50 (12.16) 47.09 (10.00) 2.16 0.148 0.40 Symptom Score 14.14 (6.03) 19.21 (3.56) 15.43 <0.001 1.02 Symptom Severity Score 16.50 (14.43) 3.79 (5.96) 21.11 1.15 SAC 26.00 (2.29) 27.67 (1.81) 9.025 0.004 0.81 M-BESS 21.58 (7.02) 19.61 (6.81) 0.988 0.325 0.29 Conclusion The present findings do not support the K-D test for the assessment of civilian trauma MTBI in an Emergency Department setting. Its utility may depend on the availability of pre-injury baseline testing and feasibility of more rapid (<1 hour) post-injury testing. Noah D. Silverberg PhD1 Teemu M. Luoto MD2 Juha Öhman MD, PhD2 Grant L. Iverson PhD3 1Division of Physical Medicine & Rehabilitation, University of British Columbia; & GF Strong Rehab Centre, Vancouver, BC, Canada 2Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland 3Department of Physical Medicine and Rehabilitation, Harvard Medical School; & Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston, MA, USA For more info and contacts: