scholarly journals Evidence for Added Value of Baseline Testing in Computer-Based Cognitive Assessment

2013 ◽  
Vol 48 (4) ◽  
pp. 499-505 ◽  
Author(s):  
Tresa M. Roebuck-Spencer ◽  
Andrea S. Vincent ◽  
Robert E. Schlegel ◽  
Kirby Gilliland

Context: Large-scale baseline cognitive assessment for individuals at risk for concussion is a common part of the protocol for concussion-surveillance programs, particularly in sports. Baseline cognitive testing is also being conducted in US military service members before deployment. Recently, the incremental validity of large-scale baseline cognitive assessment has been questioned. Objective: To examine the added value of baseline cognitive testing in computer-based neuropsychological assessment by comparing 2 methods of classifying atypical performance in a presumed healthy sample. Design: Cross-sectional study. Setting: Military base. Patients or Other Participants: Military service members who took the Automated Neuropsychological Assessment Matrix (ANAM) before and after deployment (n = 8002). Main Outcome Measure(s): Rates of atypical performance in this healthy, active-duty sample were determined first by comparing postdeployment scores with a military normative database and then with each individual's personal baseline performance using a reliable change index. Results: Overall rates of atypical performance were comparable across these 2 methods. However, these methods were highly discordant in terms of which individuals were classified as atypical. When norm-referenced methods were used, 2.6% of individuals classified as normal actually demonstrated declines from baseline. Further, 65.7% of individuals classified as atypical using norm-referenced scores showed no change from baseline (ie, potential false-positive findings). Conclusions: Knowing an individual's baseline performance is important for minimizing potential false-positive errors and reducing the risks and stresses of misdiagnosis.

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S176-S176
Author(s):  
Amy Lynham ◽  
Jeremy Hall ◽  
Ian Jones ◽  
James Walters

Abstract Background Cognition is impaired in patient with psychosis and is predictive of functional outcomes. Despite this, cognitive function is not routinely assessed in clinical services in the United Kingdom. Collecting cognitive data for research is also labour-intensive and expensive. Web-based assessments may be a solution for these issues but to date, these have not been utilised in patients with psychosis or other psychiatric disorders. Methods We have developed an online cognitive battery for use in psychosis research (and broader mental health research) in collaboration with The Many Brains Project, website developers, patients and clinicians (Cardiff ONline Cognitive Assessment, CONCA). Tasks were selected to measure the domains outlined by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative. We have undertaken a cross-validation study in those with schizophrenia (N=15), bipolar disorder (N=16), depression (N=15) and healthy controls (N=19) to compare the online tasks with the MATRICS battery. Following validation, we invited participants from the Cardiff Cognition in Schizophrenia Study (CardiffCOGS) and the National Centre for Mental Health (NCMH) to complete CONCA. Results Correlations between CONCA and MATRICS tasks ranged from 0.25 to 0.73 in our validation sample (N=65). A total of 6960 individuals were invited to participate and 1227 consented to take part. There was a better response rate from NCMH participants (who were recruited more recently) compared to those from CardiffCOGS. Online participants recruited from NCMH were more highly educated (W=1171600, p<0.001) and more likely to be professionals (χ2(1)=5.4, p=0.02) than the original NCMH cohort. In CardiffCOGS, online participants were more highly educated than non-responders (W=7786.5, p=0.003). A total of 887 individuals met inclusion criteria for our analyses including 43 participants with schizophrenia, 146 with bipolar disorder, 261 with unipolar depression, 187 controls and 250 participants with other psychiatric disorders. Consistent with studies using offline assessments, participants with schizophrenia were the most severely impaired group (compared to controls: g=1.36, p<0.001), exhibiting greater impairments than participants with depression (g=1.04, p<0.001) and bipolar disorder (g=0.71, p=0.002). Of note, lower performance on the battery was associated with poorer functional outcome as assessed using the World Health Organisation’s Disability Assessment Scale (B=-1.77, SE=0.3, p=5.8 x 10–9). Discussion Web-based cognitive testing is a suitable method for collecting large-scale data in psychiatric populations, although there was some evidence of recruitment bias. The results of the validation and recruitment phases were used to inform selection of the final battery. We consulted with patients and health professionals from a youth psychosis service and NCMH’s patient involvement group to create a user-friendly interface and will continue to work with these groups to develop clinically useful feedback to facilitate patient monitoring in early intervention psychosis services.


2017 ◽  
Vol 24 (4) ◽  
pp. 512-519 ◽  
Author(s):  
Leigh E Charvet ◽  
Michael Shaw ◽  
Ariana Frontario ◽  
Dawn Langdon ◽  
Lauren B Krupp

Background: Cognitive impairment is a common and troubling feature of pediatric-onset multiple sclerosis (POMS). Brief cognitive assessment in the outpatient setting can identify and longitudinally monitor cognitive involvement so that early intervention is possible. Objectives: The goal of this study was to measure the sensitivity of two cognitive assessment approaches that are brief, repeatable, and suitable for clinical practice and for multicenter investigation. Methods: Participants with POMS ( n = 69) were consecutively evaluated as part of outpatient neurologic visits and compared to healthy control participants (HC, n = 66) using the Brief International Cognitive Assessment for MS (BICAMS) approach and timed information processing measures from Cogstate, a computer-based assessment. Results: There was strong agreement in the detection rate of impairment between both assessments, with 26% for the BICAMS and 27% for Cogstate. Two of the Cogstate tasks were the most sensitive individual measures. Conclusion: Both the BICAMS and Cogstate timed processing measures offer practical, sensitive, and standardized approaches for cognitive screening assessment in POMS.


1988 ◽  
Vol 32 (14) ◽  
pp. 831-835
Author(s):  
Benjamin A. Fairbank

Data gathered in large-scale computer-based cognitive laboratories occasionally appear less orderly than data gathered on similar tasks in laboratories where close interaction between subject and experimenter is possible. The present research addressed the question of whether the use of robust statistics could make such data appear more orderly and lawful. Of related interest was the question of whether parameters which describe whole distributions of data, rather than only means and standard deviations, could be used to establish reliable and valid individual differences. For the large sample sizes used here the robust estimators did not outperform standard statistics. The distribution parameters were not sufficiently reliable to be useful in characterizing psychological processes.


2019 ◽  
Author(s):  
Amanda Kvarven ◽  
Eirik Strømland ◽  
Magnus Johannesson

Andrews & Kasy (2019) propose an approach for adjusting effect sizes in meta-analysis for publication bias. We use the Andrews-Kasy estimator to adjust the result of 15 meta-analyses and compare the adjusted results to 15 large-scale multiple labs replication studies estimating the same effects. The pre-registered replications provide precisely estimated effect sizes, which do not suffer from publication bias. The Andrews-Kasy approach leads to a moderate reduction of the inflated effect sizes in the meta-analyses. However, the approach still overestimates effect sizes by a factor of about two or more and has an estimated false positive rate of between 57% and 100%.


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