A battery approach for measuring neuropsychological change

• Published in: Archives of clinical neuropsychology 2006, Vol.21 (1), p.83-89
• Main Authors: Woods, Steven Paul, Childers, Meredith, Ellis, Ronald J., Guaman, Stephanie, Grant, Igor, Heaton, Robert K.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Cognition Disorders - physiopathology; Disease Progression; Female; HIV Infections - psychology; Humans; Longitudinal Studies; Male; Medical sciences; Middle Aged; Neuropsychological assessment; Neuropsychological Tests; Practice (Psychology); Psychology. Psychoanalysis. Psychiatry; Psychometrics. Diagnostic aid systems; Psychopathology. Psychiatry; Quantitative methods; Reproducibility of Results; Sensitivity and Specificity; Techniques and methods; Test reliability; Time Factors
• ISSN: 0887-6177; 1873-5843
• DOI: 10.1016/j.acn.2005.07.008

The accurate interpretation of serial neuropsychological testing is a fundamental activity of neuropsychologists in clinical and research settings. Although prior research supports the construct validity of several individual tests for the reliable measurement of cognitive change, neuropsychologists are often interested in detecting changes in cognitive functioning across a battery of tests. In the present study, we examined the specificity of a modified Reliable Change Index (RCI) methodology applied across a focused battery of commonly used neuropsychological tests. Fifty-seven healthy controls underwent neuropsychological assessment at two time points separated by approximately 1 year. Test–retest reliability coefficients and standard RCI confidence intervals for the individual tests were broadly comparable with prior research in healthy populations. Battery change scores were generated by calculating z-scores of change for each individual test, which were summed across the entire test battery. The RCI methodology was applied to the summed z-score to provide a 90% confidence interval as an indicator of overall cognitive stability. These battery RCI normative standards demonstrated adequate specificity when applied to 29 persons with HIV-1 infection who were classified as medically and neurologically stable. Findings from this study may be useful for both clinicians and researchers seeking normative standards for determining reliable changes in performance across a commonly used battery of neuropsychological tests.