Section Editor Response

Dear Editor-in-Chief: Evidenced-based practice in the primary care or sports medicine setting has, as a major tenet, the principle of using high-quality published and scientifically sound research that demonstrates improved clinical outcomes to justify the addition of new drugs, therapies, procedures, or other interventions to medical practice. The overarching question that must be answered for every preventive service is whether evidence suggests that provision of the service would improve health outcomes if implemented in a general population (3). Baseline neuropsychological testing for athletes is marketed in such a way as to suggest that it will prevent bad outcomes such as death or prolonged postconcussive symptoms. Dr. Randolph (1) has used a comprehensive evidence-based review to demonstrate clearly that, at this time, baseline neuropsychological testing does not have evidence to support that it prevents problems or improves outcomes. Dr. Shuttleworth-Edwards (2) appears to revert to anecdote-driven practice and provides no proof of prevention of problems or improved outcomes through the use of baseline neuropsychological testing. Despite misleading media accounts and heavy marketing by companies that offer these tests, sports medicine practitioners should resist the seductive and simplistic appeal to use such products. To advocate for the addition of baseline neuropsychological testing for athletes at this time is scientifically unfounded and financially irresponsible and should be roundly condemned for confusing and raising false expectations in the athletes who are subjected to it, as well as adding additional burden to an already overtaxed medical system. Christopher A. McGrew, MD, FACSM University of New Mexico Health Sciences Center Department of Family and Community Medicine Director, Primary Care Sports Medicine Fellowship Albuquerque, NM E-mail: [email protected]