Validity of an Automated Balance Error Scoring System

The balance error scoring system (BESS) is a human-scored, field-based balance test used in cases of suspected concussion. Recently developed instrumented alternatives to human scoring carry substantial advantages over traditional testing, but thus far report relatively abstract outcomes that may not be useful to clinicians or coaches. In contrast, the automated assessment of postural stability (AAPS) is a computerized system that tabulates error events in accordance with the original description of the BESS. This study compared AAPS and human-based BESS scores. A total of 25 healthy adults performed the modified BESS. Tests were scored twice each by 3 human raters and the computerized system. Interrater (between human) and intermethod (AAPS vs human) agreement (interclass correlation coefficient2,1) were calculated alongside Bland–Altman limits of agreement. Interrater analyses were significant (P < .01) and demonstrated good to excellent agreement. Intermethod agreement analyses were significant (P < .0...