Comparing the test of practical judgment with the neuropsychological assessment battery judgment subtest in a neurodegenerative disease clinic population

Abstract

The Test of Practical Judgment (TOP-J) and the Judgment subtest from the Neuropsychological Assessment Battery (NAB-JDG) are both brief interview-based measures that assess judgment. This study compared estimates of judgment obtained from these measures in a neurodegenerative disease population. Records from 61 referrals seen for neuropsychological evaluation in a neurodegenerative disorders clinic were reviewed. Measures of interest included the TOP-J and NAB-JDG. Concordance correlation coefficients (CCC) and root mean square differences (RMSD) were calculated between judgment T-scores. Discrepancy scores were calculated by subtracting NAB-JDG scores from TOP-J scores. CCC showed poor agreement between the judgment measures, with evidence of fixed bias, such that the NAB-JDG systematically generates higher scores than the TOP-J. This fixed bias was present whether NAB-JDG scores are demographically adjusted or unadjusted. There was no evidence of proportional bias. In a neurodegenerative disease clinic population, the TOP-J and NAB-JDG provide estimates of judgment ability that are systematically different. These two measures may be assessing different aspects within the larger construct of judgment and the inconsistency between measures would contraindicate using them interchangeably. Clinicians will need to carefully consider patient characteristics, clinical needs, and review specific item content when selecting between these measures.

Assessment of judgment ability in a Brazilian sample of patients with mild cognitive impairment and dementia

“…Furthermore, items on the NAB JDG primarily relate to safety and hygiene issues instead of tapping into high-level judgment dilemmas that require participants to engage in real-world decision-making. 12 In a recent study, Durant and colleagues 16 compared estimates of judgment obtained from TOP-J/9 and NAB-JDC in a neurodegenerative disease population. There was a significant amount of inconsistency between these measures, suggesting that they may be measuring different aspects of judgment and would contraindicate using the measures interchangeably.…”

“…In a recent study, Durant and colleagues 16 compared estimates of judgment obtained from TOP-J/9 and NAB-JDC in a neurodegenerative disease population. There was a significant amount of inconsistency between these measures, suggesting that they may be measuring different aspects of judgment and would contraindicate using the measures interchangeably.…”

Pilot validation of a verbal practical judgement assessment (VPJ) among community-dwelling older adults in Israel: the first step toward a national standard

“…Judgement is defined as the ability to assess a situation and make appropriate decisions, based on relevant information, context, possible alternative solutions, and understanding of the outcomes. Deficits in the ability to judge can compromise a person's safety and function and could indicate an increased need for external support 11 . It has been found that both decreases in cognitive and functional status are associated with decreased ability in judgement 12 .…”

Evaluation des processus impliqués dans l’autonomie cognitive chez des patients cérébrolésés atteints de pathologies dégénératives ou de lésions acquises non-évolutives.

“…A notre connaissance toutefois, aucune modélisation de la perte d’autonomie n’a été proposée, l’autonomie reposant sur différents jugements cognitivo-émotionnels chez les participants sains. Ces derniers renvoient à l’évaluation attentive d’une situation et à la génération d’une ou plusieurs options pour atteindre un but en se référant aux informations pertinentes, au contexte, aux solutions potentielles et à leurs conséquences (Capucho & Brucki, 2011; Durant et al, 2018; Rabin et al, 2007; Woods et al, 2000). L’autonomie, à la différence du jugement, suppose d’identifier seul une situation problématique et d’en évaluer la gravité avant d’y apporter une éventuelle solution grâce au jugement.…”