The use, abuse, and future of neuropsychologic testing in mild traumatic brain injury.

A comparison is made between abbreviated formal neuropsychologic testing programs and computerized neuropsychologic programs such as ImPACT, Headminders, CogSport, and others. Issues of time, cost, need for supervision, liability, and validation are discussed. Specific time and monetary costs per athlete are calculated for each program. The estimated cost is between $22 and $27 per athlete for abbreviated formal testing and between $669 and $677 per athlete for computerized testing. Because of the significant time and monetary costs of neuro-psychologic testing, its lack of validation in deter-mining recovery, limited validation and utility in diagnosing concussion, and its numerous logistic concerns, its widespread use is probably not justified until appropriate data are published and costs contained. Recommendations for alternative evaluation techniques are suggested.