Bernstein Matthew T, Resch Zachary J, Ovsiew Gabriel P, Soble Jason R
Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.
Department of Psychology, Rosalind Franklin University of Medicine and Science, IL, North Chicago, USA.
Neuropsychol Rev. 2021 Jun;31(2):349-359. doi: 10.1007/s11065-020-09468-y. Epub 2021 Jan 15.
Thorough assessment of performance validity has become an established standard of practice in neuropsychological assessment. While there has been a large focus on the development and cross-validation of embedded performance validity tests (PVTs) in recent years, new freestanding PVTs have also been developed, including the Word Choice Test (WCT) as part of the Advanced Clinical Solutions Effort System. And, while the WCT's general utility for identifying invalid performance has been demonstrated in the ensuing decade since its initial publication, optimal cut-scores and associated psychometric properties have varied widely across studies. This study sought to synthesize the existing diagnostic accuracy literature regarding the WCT via a systematic review and to conduct a meta-analysis to determine the performance validity cut-score that best maximizes sensitivity while maintaining acceptable specificity. A systematic search of the literature resulted in 14 studies for synthesis, with eight of those available for meta-analysis. Meta-analytic results revealed an optimal cut-score of ≤ 42 with 54% sensitivity and 93% specificity for identifying invalid neuropsychological test performance. Collectively, the WCT demonstrated adequate diagnostic accuracy as a PVT across a variety of populations. Recommendations for future studies are also provided.
对表现效度进行全面评估已成为神经心理学评估中既定的实践标准。近年来，虽然人们大量关注嵌入式表现效度测试（PVT）的开发和交叉验证，但也开发了新的独立PVT，包括作为高级临床解决方案努力系统一部分的单词选择测试（WCT）。并且，尽管自WCT首次发表后的十年里，其在识别无效表现方面的一般效用已得到证实，但不同研究中的最佳临界分数和相关心理测量特性差异很大。本研究旨在通过系统评价综合有关WCT的现有诊断准确性文献，并进行荟萃分析，以确定在保持可接受的特异性的同时能最大程度提高敏感性的表现效度临界分数。对文献进行系统检索后，得到14项可供综合分析的研究，其中8项可用于荟萃分析。荟萃分析结果显示，识别无效神经心理学测试表现的最佳临界分数为≤42，敏感性为54%，特异性为93%。总体而言，WCT作为一种PVT在各种人群中都显示出足够的诊断准确性。同时还提供了对未来研究的建议。
