HQ BaselineQuality control
The 'Garbage In, Garbage Out' Problem: Why Your School's Baseline Program Might Be Doing More Harm Than Good
When baseline testing is done poorly, the data doesn't just become useless — it can become dangerous.
This post isn’t designed to discourage baseline testing. It’s designed to ensure that when baseline testing is done, it’s done with the quality controls that make the data clinically useful rather than clinically dangerous.
The specific danger
A poorly administered baseline creates a false sense of security. Here’s the specific danger: if an athlete’s baseline was taken in a distracting environment with low effort — resulting in artificially depressed scores — their “healthy” cognitive performance looks worse than it actually is. After a real concussion, their post-injury scores might actually improve compared to this flawed baseline, because they’re now in a quiet clinic and genuinely trying. The result: a concussed athlete is cleared to return to play because their data shows “improvement” over baseline. This scenario is not hypothetical — it’s a recognized risk in the concussion management literature, discussed by researchers including Schatz and colleagues in Applied Neuropsychology.
When normative data is the safer fallback
Counterintuitively, this means that no baseline — where clinicians use population normative data for comparison — can sometimes be safer than a bad baseline. Normative data, while less personalized, at least represents genuine cognitive performance under standardized conditions. Research from the CARE Consortium, published in the American Journal of Sports Medicine (2024), found that normative data performed adequately for the majority of athletes. See also what normative data can and can’t do.
The quality checklist
A quality checklist for any baseline testing program should include: Is the testing environment quiet, supervised, and distraction-free? Are athletes tested in small groups (≤4) or individually? Are phones collected before testing? Are athletes screened for fatigue, illness, and recent exercise? Is every test reviewed for validity indicators before being stored? Are invalid tests re-administered? Is the administrator trained in the specific testing platform? Is there a written protocol ensuring consistency across administrators and sessions?
If the answer to any of these questions is “no,” the program has quality gaps that may undermine the clinical value of the data it produces. See also how the testing environment affects data.
How we help
At Headquarters, we provide baseline administration training and quality assurance consultation for school programs. We’d rather help you do it right than see it done poorly.