Roebuck-Spencer Tresa M, Glen Tannahill, Puente Antonio E, Denney Robert L, Ruff Ronald M, Hostetter Gayle, Bianchini Kevin J
Jefferson Neurobehavioral Group, Metairie, LA, USA.
Neuropsychology, Inc., Jacksonville, FL, USA.
Arch Clin Neuropsychol. 2017 Jun 1;32(4):491-498. doi: 10.1093/arclin/acx021.
The American Medical Association Current Procedural Panel developed a new billing code making behavioral health screening a reimbursable healthcare service. The use of computerized testing as a means for cognitive screening and brief cognitive testing is increasing at a rapid rate. The purpose of this education paper is to provide information to clinicians, healthcare administrators, and policy developers about the purpose, strengths, and limitations of cognitive screening tests versus comprehensive neuropsychological evaluations. Screening tests are generally brief and narrow in scope, they can be administered during a routine clinical visit, and they can be helpful for identifying individuals in need of more comprehensive assessment. Some screening tests can also be helpful for monitoring treatment outcomes. Comprehensive neuropsychological assessments are multidimensional in nature and used for purposes such as identifying primary and secondary diagnoses, determining the nature and severity of a person's cognitive difficulties, determining functional limitations, and planning treatment and rehabilitation. Cognitive screening tests are expected to play an increasingly important role in identifying individuals with cognitive impairment and in determining which individuals should be referred for further neuropsychological assessment. However, limitations of existing cognitive screening tests are present and cognitive screening tests should not be used as a replacement for comprehensive neuropsychological testing.
美国医学协会现行程序小组制定了一项新的计费代码,使行为健康筛查成为一项可报销的医疗服务。将计算机化测试用作认知筛查和简短认知测试手段的情况正在迅速增加。本教育论文的目的是向临床医生、医疗保健管理人员和政策制定者提供有关认知筛查测试与全面神经心理学评估的目的、优势和局限性的信息。筛查测试通常简短且范围有限,可以在常规临床就诊期间进行,有助于识别需要更全面评估的个体。一些筛查测试也有助于监测治疗结果。全面神经心理学评估本质上是多维度的,用于识别主要和次要诊断、确定个体认知困难的性质和严重程度、确定功能限制以及规划治疗和康复等目的。认知筛查测试有望在识别认知障碍个体以及确定哪些个体应转介进行进一步神经心理学评估方面发挥越来越重要的作用。然而,现有认知筛查测试存在局限性,不应将其用作全面神经心理学测试的替代品。