Schulz-Heik R Jay, Fahimi Atoossa, Durazzo Timothy C, Friedman Marcelle, Bayley Peter J
War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, San Jose, California, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA.
Appl Neuropsychol Adult. 2020 May-Jun;27(3):256-266. doi: 10.1080/23279095.2018.1534735. Epub 2019 Jan 11.
Numerous advantages of and concerns about computerized neuropsychological assessment systems have been noted. Here we report a program evaluation of incorporating a computerized system, the Cambridge Neuropsychological Test Automated Battery (CANTAB), in our tertiary assessment center for Veterans. Patients were 23 consecutive referrals to the Western War Related Illness and Injury Study Center, an interdisciplinary assessment center within the Veterans Affairs Healthcare System for Veterans with complex medical presentations. Patients were administered both the CANTAB and a brief traditional neuropsychological battery. The correlation between global composite scores from each method was .71 ( < .05), indicating "good" concordance. Concordance was "fair" to "good" for scores on specific cognitive domains. However, concordance was lower when classifying patients' cognition as "impaired" or "not-impaired" based on a cutoff score. Despite the CANTAB's primarily visuospatial interface, discrepancy between the two methods' scores was not associated with patients' visuospatial abilities. The two methods were similarly sensitive to deficits associated with posttraumatic stress disorder, which is prevalent among the Center's patients. The CANTAB was judged to be a valid and useful complement to, but not an acceptable alternative to a traditional neuropsychologist-administered cognitive assessment battery for the Center's specific patients and needs.
计算机化神经心理评估系统的诸多优势和相关问题已被提及。在此,我们报告一项关于在我们为退伍军人设立的三级评估中心引入计算机化系统——剑桥神经心理测试自动成套系统(CANTAB)的项目评估。患者为连续转诊至西部战争相关疾病与损伤研究中心的23名患者,该中心是退伍军人事务医疗系统内一个针对有复杂医疗状况的退伍军人的跨学科评估中心。对患者同时进行了CANTAB测试和简短的传统神经心理成套测试。两种方法的总体综合得分之间的相关性为0.71(<0.05),表明具有“良好”的一致性。在特定认知领域的得分方面,一致性为“中等”至“良好”。然而,根据临界值将患者的认知分类为“受损”或“未受损”时,一致性较低。尽管CANTAB主要是视觉空间界面,但两种方法得分的差异与患者的视觉空间能力无关。两种方法对与创伤后应激障碍相关的缺陷同样敏感,而创伤后应激障碍在该中心的患者中很常见。对于该中心的特定患者和需求而言,CANTAB被判定为传统神经心理学家实施的认知评估成套测试的有效且有用的补充,但并非可接受的替代方法。