Concussion education · For patients and families

Baseline vs. Post-Injury Concussion Testing

Athletes often have a baseline test on file. Most adults in car crashes never do. That does not leave their evaluation without a point of comparison; it changes where the comparison comes from.

By Ben Thayer, Co-Founder & Co-Owner · 3 min read

Who this is for: Written for adults with no baseline test on file, and for attorneys and providers wondering how results are compared.

Key takeaways

Baseline testing happens before an injury, usually in organized sports. Post-injury testing measures current function.
Without a baseline, results are compared with reference data from people of similar age and background.
Without a baseline, context matters more: education, history, prior conditions and family descriptions of “before.”
A treating provider may decide that follow-up testing would help track change over time.
The absence of a baseline is common and does not make post-injury findings meaningless.

Two different kinds of testing

Baseline testing is done before any injury, usually for athletes in organized sports, so that later post-injury results can be compared with that person's own earlier performance. Post-injury testing is done after a suspected head injury to measure current function.

Most adults involved in car crashes and falls have never had a baseline test. Their post-injury results are compared with reference data from people of similar age and background.

Numbers are a starting point for interpretation, not the final word.

Can testing be useful without a baseline?

Bright, calm clinic exam room — Braintree testing takes place at the referring provider’s office.

Yes. Reference data let the neurologist see how a person's results compare with typical performance. The neurologist also weighs the patient's education, history and pre-existing conditions, along with what the patient and family report about how they functioned before. Without a baseline, interpretation leans more heavily on this context, which is why a complete history on the referral matters.

How reference data are built

Reference data come from large groups of people tested under standardized conditions, often grouped by age and other factors. That is what makes it possible to say whether a result falls within a typical range. The neurologist then decides how much weight each result deserves, given the patient's background, effort and symptoms. Numbers are a starting point for interpretation, not the final word.

Related in this series: Eye-Movement (Oculomotor) Testing, Neurocognitive Testing and Prior Injuries and Concussion Evaluation: What to Disclose. For the full overview, start with our guide, TBI Diagnostics: What Tests and Reports Show.

Other sources of “before” information

School records, job performance reviews, prior medical records and family descriptions can all show what a person's function looked like before the injury. Someone who managed a demanding job without difficulty and now struggles with routine tasks is showing a meaningful change, whatever any single number says.

A person who managed a demanding job without difficulty and now struggles with routine tasks is showing a meaningful change.

Follow-up testing as a personal comparison

Physician in a white coat speaking with a patient — A neurologist interprets the report; the treating provider then receives a copy.

After an initial post-injury test, a treating provider may decide that a later follow-up would help track change. In that case the first test becomes a point of comparison for that patient. The decision belongs to the provider.

What this means for patients and attorneys

Patients: do not worry if you never had baseline testing. Most people have not. Be honest about your history and about what has changed.

Attorneys: the absence of a baseline is common and does not make post-injury findings meaningless. Reports describe findings relative to reference data and clinical context. We do not comment on legal significance.

Emergencies

Testing of any kind is not for emergencies. A worsening headache, repeated vomiting, a seizure, confusion or weakness needs the ER immediately.

Frequently asked questions

I never had a baseline test. Is testing still useful?

Yes. Results are compared with reference data and read alongside your history.

Can follow-up testing show change?

A repeat test can serve as a personal comparison, if your provider orders it.

We diagnose. You treat.

Mobile, physician-reviewed concussion and TBI diagnostics for Florida providers and their accident patients. Reports go to a neurologist ahead of the neuro evaluation; the referring provider then receives a copy for advanced imaging and treatment recommendations.

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Sources

This article is educational and is not medical or legal advice. If this is a medical emergency, call 911.