Validität und Reliabilität von Beschwerdenvalidierungstests und -indikatoren

2006 ◽  
Vol 17 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Nina Blaskewitz ◽  
Thomas Merten

Zusammenfassung: Beschwerdenvalidierungstests (BVT) dienen zur Überprüfung der Gültigkeit erhaltener Testprofile. Im Rahmen eines Analogdesigns wurden drei BVT (Medical Symptom Validity Test MSVT, Amsterdamer Kurzzeitgedächtnistest AKGT, One-in-Five Test) sowie eine Reihe von Beschwerdenvaliditätsindikatoren anderer Tests auf ihre Güte überprüft. 24 jüngere Erwachsene mit dem Mindestbildungsabschluss Abitur zeigten in der Untersuchung entweder ihre volle Leistung oder waren instruiert, entsprechend einem detaillierten Szenario überzeugend kognitive Störungen vorzutäuschen. Neben den drei BVT wurden folgende neuropsychologische Tests durchgeführt: der Trail Making Test (TMT), der Rey Complex Figure Test and Recognition Trial (RCFT), der Test d2, der Judgment of Line Orientation Test (JLO) und das Zahlennachsprechen des HAWIE-R, woraus auch die Reliable Digit Span (RDS) bestimmt wurde. Für den MSVT, den AKGT und die RDS konnten durch Testwiederholung nach zwei bis drei Tagen bzw. Einsatz einer Äquivalenzform des MSVT Reliabilitätsangaben erhalten werden. Für den AKGT und den MSVT-Durchgang Verzögerte Wiedererkennung ergaben sich zufrieden stellende Reliabilitätskoeffizienten (mit Phi-Koeffizienten von je 0.92), die für die RDS niedriger ausfielen (0.74). Die Ergebnisse zeigen auch eine gute Klassifikationsgüte für die BVT und die RDS, die zwischen 100 % (AKGT) und 79 % (One-in-Five Test) lag. Andere Validitätsindikatoren, die aus TMT, d2 und JLO ermittelt werden, schnitten schlechter ab. Während BVT gegenwärtig die best entwickelte Methodenklasse zur Diagnostik suboptimalen Leistungsverhaltens darstellen, sollte die Güte von Beschwerdenvaliditätsindikatoren, die aus Standardtests abgeleitet werden, deutlich besser überprüft werden, bevor ihr Einsatz in der Einzelfalldiagnostik in Frage kommt.

Author(s):  
Richard Gnassounou ◽  
Bénédicte Defontaines ◽  
Séverine Denolle ◽  
Stéphanie Brun ◽  
Raphaël Germain ◽  
...  

Abstract Objective: To compare the administration of neuropsychological tests by teleneuropsychology (TeleNP) and face to face (F-F) in order to determine the feasibility and reliability of TeleNP. Method: At the inclusion visit, all participants underwent a traditional F-F neuropsychological assessment as part of their standard care. Four months after inclusion, they were randomized to undergo an additional neuropsychological assessment either by F-F administration or by TeleNP. Results: A total of 150 adults with cognitive complaints, but with no major cognitive or sensorial impairment were included. At 4 months, 69 participants were randomized in the F-F arm and 71 in TeleNP arm (10 lost in the follow-up). The overall satisfaction was high: 87.1% in the TeleNP arm were “very satisfied”, and 82.9% indicated no preference between F-F and TeleNP. In agreement with previous data from the literature, neuropsychological assessments gave similar results across both administration conditions for a large majority of tests [Mini-Mental State Examination (MMSE), Free and Cued Selective Reminding Test (FCSRT) French version, Mahieux gestural praxis battery, Frontal Assessment Battery (FAB), time of completion of the Trail making Test (TMT) A and B, number of errors of the TMT B, Rey complex figure test, categorical et phonological verbal fluency tests] and minor differences for others [80-picture naming test (DO-80), FAB, Digit Span forward and backward and number of errors in the TMT A]. Conclusions: TeleNP is a promising method to be able to test patients as an alternative to F-F condition. Before this procedure can be generalized, it is now necessary to standardize the adaptation of certain tests and to test them in populations with more significant cognitive disorders.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Simona Lattanzi ◽  
Michela Coccia ◽  
Alessandra Pulcini ◽  
Claudia Cagnetti ◽  
Federica Lucia Galli ◽  
...  

Abstract The impact of reperfusion therapies on cognition has been poorly explored and little knowledge exists. We explored the influence of endovascular treatment (EVT) on cognitive outcome in patients with anterior circulation ischemic stroke. Patients presenting with ischemic stroke due to anterior large vessel occlusion who underwent intravenous thrombolysis (IVT) alone or EVT plus IVT were recruited. Cognitive abilities were evaluated at 6 months from stroke through a neuropsychological test battery. A total of 88 patients with a mean age of 66.3 ± 12.9 years were included, of which 38 treated with IVT alone and 50 with IVT plus EVT. Compared to patients treated with IVT alone, patients who received EVT plus IVT performed significantly better at the neuropsychological tests exploring executive functions, attention, abstract reasoning, visuospatial ability, visual and verbal and memory. At multivariable regression analysis, the EVT was independently associated with the 6-month cognitive performance after the adjustment for age, sex, admission National Institutes of Health Stroke Scale score, systolic blood pressure, glucose level, Alberta Stroke Program Early CT score, side of stroke, site of occlusion, and Back Depression Inventory score [Stroop Test Word Reading: adjβ = 13.99, 95% confidence interval (CI) 8.47–19.50, p < 0.001; Stroop Test Colour Naming: adjβ = 6.63, 95% CI 2.46–10.81, p = 0.002; Trail Making Test-A: adjβ = − 92.98, 95% CI − 153.76 to − 32.20, p = 0.003; Trail Making Test-B: adjβ = − 181.12, 95% CI − 266.09 to − 96.15; p < 0.001; Digit Span Test Forward: adjβ = 1.44, 95% CI 0.77–2.10, p < 0.001; Digit Span Test Backward: adjβ = 1.10, 95% CI 0.42–1.77, p = 0.002; Coloured Progressive Matrices: adjβ = 5.82, 95% CI 2.71–8.93, p < 0.001; Rey Complex Figure Test-Copy: adjβ = 6.02, 95% CI 2.74–9.30, p < 0.001; Rey Complex Figure Test-Immediate recall: adjβ = 6.00, 95% CI 2.34–9.66, p = 0.002; Rey Complex Figure Test-Delayed recall: adjβ = 5.73, 95% CI 1.95–9.51, p = 0.003; Rey Auditory Verbal Learning Test-Immediate recall: adjβ = 12.60, 95% CI 6.69–18.52, p < 0.001; Rey Auditory Verbal Learning Test-Delayed recall: adjβ = 1.85, 95% CI 0.24–3.45, p = 0.025]. Patients treated with EVT plus IVT had better cognitive performance than patients treated with IVT alone at 6 months from anterior circulation ischemic stroke.


2020 ◽  
Vol 267 (S1) ◽  
pp. 153-159 ◽  
Author(s):  
Dilara Aktert Ayar ◽  
Emre Kumral ◽  
Nese Celebisoy

AbstractCognitive deficits mainly involving visuospatial functions have been defined in patients with bilateral and even unilateral vestibular loss (UVL). We compared the cognitive test results of 21 patients with acute UVL with age- and education-matched healthy controls. The diagnosis of UVL was based on the clinical findings, a normal magnetic resonance imaging with diffusion-weighted sequence and canal paresis on the affected side on caloric testing. Cognitive tests assessing visuospatial functions (Benton’s Judgment of Line Orientation test, Verbal and non-verbal Cancellation tests, Rey–Osterrieth Complex Figure test) and global mental status, verbal memory, learning, retention of information, and recalling (Mini Mental State Examination, Oktem Verbal Memory Process Test, Forward and Backward Digit span) were used in addition to Beck depression and Anxiety inventories. Abnormalities in verbal and non-verbal cancellation tests (p < 0.005), Benton’s Judgment of Line Orientation test (p = 0.042) and backward digit span (p = 0.029) was found. A very prominent difference regarding Beck depression (p = 0.012) and anxiety inventories (p < 0.001) was present. On multiple regression analysis, the abovementioned cognitive tests’ results lost their statistical significance (p > 0.05) when depression and anxiety scores were taken into consideration. The severity of canal paresis was found to be correlated with Benton’s Judgment of Line Orientation test (p = 0.008, r = − 0.5639) and Rey–Osterrieth Complex Figure test copying scores (p = 0.029, r = − 0.477). Comparison of all the results in right- and left-sided lesions did not reveal a significant difference (p > 0.05). Vestibular patients are prone to develop anxiety, and depression. Deficits in visuospatial functions, mental manipulation, psychomotor speed and short-term memory detected in our patients with acute UVL seem to be enhanced by accompanying anxiety and depression. The extent of vestibular dysfunction was correlated with the severity of deficits in visuospatial skills. Lesion side did not cause alterations in cognitive or emotional status.


2004 ◽  
Vol 15 (2) ◽  
pp. 81-90 ◽  
Author(s):  
Thomas Merten ◽  
Matthias Henry ◽  
Robin Hilsabeck

Zusammenfassung: In der neuropsychologischen Diagnostik, mehr noch aber in der Begutachtung gewinnen Symptomvalidierungstests (SVT) zur Untersuchung der Leistungsmotivation zunehmend an Bedeutung. In einer Analogstudie wurde die Güte zweier international bekannter Verfahren (Word Memory Test; Amsterdam Short Term Memory Test) sowie einer Neuentwicklung (Word Completion Memory Test) untersucht. Zusätzlich wurden Leistungstests eingesetzt: der Trail Making Test (TMT), der Complex Figure Test sowie die Standard Progressive Matrices (SPM). Eine Gruppe von 10 experimentellen Simulanten wurde spezifisch auf die Vortäuschung von Gedächtnisstörungen vorbereitet, während eine Kontrollgruppe (n = 10) optimale Testanstrengung zeigen sollte. Alle SVT führten im Gegensatz zu den Simulationsmarkern des TMT und der SPM zu einer ausgezeichneten Klassifikationsgüte (95-100 %). Die neuropsychologischen Leistungsmaße wiesen zwar signifikante Gruppenunterschiede aus, zeigten aber auch eine nicht unbedeutende Überlappung der Verteilungen. Mehr Studien sind notwendig, um den SVT in den deutschsprachigen Ländern den Platz zu sichern, den sie international aktuell in der klinisch-neuropsychologischen Forschung und Praxis einnehmen.


1994 ◽  
Vol 24 (3) ◽  
pp. 152-162 ◽  
Author(s):  
Brad C. Shannon ◽  
Shirley G. Tollman

In view of the debate regarding the behavioural sequelae accompanying multiple sclerosis (MS), this study aimed to identify the deficits underlying observed behavioural performance difficulties in 24 MS sufferers. Qualitative and quantitative assessment instruments were employed, that is, Christensen's formalization of Luria's Neuropsychological Investigation, the Trail Making Test and Rey's Complex Figure Test. Results were analysed using syndrome analysis, which proceeded according to a hypothetico-deductive process, based on the principle of double dissociation of function. Five underlying factors were identified, namely: fatigability; information overload; disturbed fine control and integration of skilled motor movements; disturbed attention, concentration and tracking; and, disturbed executive control. Subjects divided into two subgroups. Those in subgroup 1 displayed fatigability, information overload and disturbed fine control and integration of skilled motor movement. In addition to these, subjects in subgroup 2 displayed disturbed attention, concentration and tracking, and disturbed executive skills. The identification of two subgroups may assist in explaining why controversy still surrounds the question of cognitive deficits in MS. It was concluded that the five underlying factors gave rise to a specific pattern of neuropsychological dysfunctioning in subjects consistent with a subcortical syndrome.


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