The fundamental psychometric status of neuropsychological batteries

Abstract

A fundamental requirement for neuropsychological assessment is dependability. Neuropsychological knowledge is dependable only if it has been validated using psychometric methods. Since batteries are used for interpretations, the psychometric validation methods that are acceptable for individual tests must be applied to batteries to produce dependable information. While the standardized battery has been validated, the flexible battery has not. Due to the probability that some tests will be impaired by chance, a flexible battery cannot produce dependable interpretations by selecting or combining test results. Localization and diagnostic assessments are obtained by comparisons. Comparisons require that the tests in a battery are invariant or have equivalent norms along with a common metric. While standardized batteries do meet these criteria, flexible batteries do not. Consequently, clinical judgment applied to a flexible battery cannot provide dependable knowledge beyond that which could be provided by a single validated individual test.

Forensic Neuropsychology and Mild Traumatic Brain Injury

“…These authors (Hom 2003;Russell et al 2005) have opined that unlike the flexible battery, if all the tests in the fixed battery have been normed on the same sample, then this allows the clinician to more clearly understand the interrelationships between test scores because there is less error related to sampling differences. Moreover, according to them, because research has compared the fixed battery's normative sample to the performance of individuals with confirmed brain impairments (of differing etiologies), the fixed battery uniquely allows examiners to empirically differentiate whether the litigant's pattern of test results is more consistent with those with confirmed brain impairments versus nonbrain impairment.…”

“…The juxtaposition of the assertions of Hom (2003) and Russell et al (2005) and Bigler (2007) may have left some neuropsychologists to question whether a flexible test batter will be admissible in those courts that require the Daubert standard. Moreover, Bigler (2007) has indicated that a few attorneys have begun using these arguments as fodder for "legal maneuvering" by indicating that the "flexible battery approach has never been properly validated and therefore remains unreliable" (p. 46).…”

“…Despite flexible test batteries being by far more popular (Sweet et al 2006), the issue of error rates is commonly cited by Hom (2003) and Russell et al (2005) as the main reason flexible test batteries do not meet the Daubert standards. Since each patient who is given a flexible battery is tested with a different combination of tests, it is very difficult to study the interrelationship between tests (Bigler 2007).…”

“…Hom (2003) and Russell et al (2005) have asserted that only the Halstead-Reitan Battery (HRB; Reitan and Wolfson 1993) meets the Daubert standards in terms of error rates and, thus, should be the only test battery admissible under Daubert. These authors (Hom 2003;Russell et al 2005) have opined that unlike the flexible battery, if all the tests in the fixed battery have been normed on the same sample, then this allows the clinician to more clearly understand the interrelationships between test scores because there is less error related to sampling differences.…”

The RAPID Neuropsychological Test Battery for Subjects Aged 50–89: From Norms to Cognitive Profile

“…Within this scope, if several studies reported the number of low test scores [3, 5-8] or low domain scores [17], they did not focus on which specific cognitive tests showed low scores. In fact, beyond the analysis of the number of low test scores, it is primarily the direct comparison between scores across different tests that is utilized for a neuropsychological interpretation [4]. This interpretation of test results could have greater clinical relevance and subsequently help clinicians to more accurately determine the cognitive profile of their patients.…”