Caracterización de autores que publicaron en la "Revista ANACEM" durante el periodo 2007 - 2018 / Characterization of authors who published in "Revista ANACEM" during 2007 - 2018

INTRODUCCIÓN: La producción científica ocupa un lugar importante en la formación de estudiantes de medicina. Siendo el objetivo de la Revista ANACEM la promoción temprana de la formación científica de los futuros profesionales médicos, es importante conocer quiénes publican en la revista y sus afiliaciones universitarias. OBJETIVO: Caracterizar a los autores de la revista ANACEM entre los años 2007 y 2018. Material y método: Estudio retrospectivo. La población estudiada fueron todos los autores con publicaciones en la revista ANACEM, excluyendo publicaciones dentro del mismo Volumen. Datos obtenidos directamente de los números publicados por ANACEM digitalmente. Se utilizó el programa Microsoft Excel® para el análisis estadístico. Resultados: Los Volúmenes 5, 6 y 7 fueron los que tuvieron más autores de pregrado. En la totalidad de los Volúmenes la mayoría de los autores fueron hombres, tanto estudiantes como docentes. Un 52,1% de los autores de pregrado fueron internos; mientras que la mayoría de los docentes, 43,7%, fueron médicos especialistas. La Universidad de Concepción fue la universidad con mayor cantidad de autores de pregrado y de docentes. Un 51,8% de los docentes informó afiliación a un hospital. La nacionalidad más común fue la chilena, con un 90,1% de la totalidad de los autores. Discusión: Se vio un aumento en la cantidad de autores de pregrado hasta el Volumen N°7, con un descenso posterior. Se atribuyó el cambio en la cantidad de autores a problemas en la gestión y divulgación de la revista. Las afiliaciones universitarias no fueron informadas siempre por los docentes. Las otras categorías siguen patrones esperados.

INTRODUCTION: Scientific production has an important place in the training of medical students, but there is no clear pictureof the authors in the ANACEM journal. For this reason, it is important to know who publishes in the magazine and their affiliations. OBJECTIVE: To characterize the authors of the ANACEM journal between 2007 and 2018. Material and method: Retrospective study. The population studied were all authors with publications in the ANACEM journal, excluding repeating publications within the same volume. The data was obtained directly from the numbers published by ANACEM digitally. The software used for statistical analysis was Microsoft Excel®. Results: Volumes 5, 6 and 7 had the most undergraduate authors. When analyzing all volumes, the majority of both student authors and professional authors were men. 52.1% of undergraduate authors were interns; while 43.7% of tutors were medical specialists. The university with the largest number of authors was Universidad de Concepción. 51.8% of professional authors reported affiliation to a hospital. The most common nationality was Chilean, with 90.1% of all authors. Discussion: There was an increase in the number of undergraduate authors up to volume n°7, with a subsequent decrease. Changes in the number of authors were attributed to problems in management and divulgation of the journal. Affiliation to universities was not always informed by professionals. The other categories follow expected patterns.

Puntajes del Concurso Nacional de Ingreso al Sistema Nacional de Servicio de Salud por universidad. Periodo 2017 ­ 2020 / Scores of the National Entrance Contest to the National Health Service System by university. Period 2017 - 2020

INTRODUCCIÓN: El Concurso Nacional de Ingreso al Sistema Nacional de Servicio de Salud (CONISS) es una de las modalidades más conocidas para acceder a una especialización médica en Chile. Se basa en la evaluación de 5 rubros diferentes y en los últimos años no ha sido capaz de cubrir la demanda de los postulantes haciendo necesario un mejor conocimiento de este. El objetivo del estudio es describir los resultados del concurso CONISS de los últimos 4 años según las universidades de los participantes. Material y método: Estudio observacional, corte transversal, descriptivo. Asociación de puntajes obtenidos por los estudiantes con su respectiva universidad, obteniéndose datos de la página de superintendencia de Salud y utilizándose software Microsoft Excel® para su procesamiento. Resultados: El total de egresados fue de 6.092, provenientes de 22 universidades chilenas. Destaca la Pontificia Universidad Católica de Chile por liderar en el rubro 1 y el puntaje total durante los 4 años y la Universidad Pedro de Valdivia por encontrarse en el último puesto. Los rubros 4 y 5 fueron los que más se completaron. Las universidades con mejor desempeño en el rubro 1 fueron también las que obtuvieron mejor desempeño en el puntaje final. Discusión: El rubro 1 es el que posee mayor importancia en el resultado final del concurso y no se encuentra estandarizado entre universidades quedando sujeto al criterio de cada institución. No completar el resto de los rubros representa una desventaja comparativa pues la mayoría tiene buenos puntajes, pero estos resultados se ven limitados en gran medida por las calificaciones.

INTRODUCTION: The National Entrance Contest to the National Health Service System (CONISS) is one of the best known modalities to access a medical specialization in Chile. It is based on the evaluation of 5 different areas (items) and in recent years it has not been able to meet the demand of the applicants, making it necessary to know more about the subject. The objective of the study is to describe the results of the CONISS by university for the last 4 years. Material and method: Observational, cross-sectional, descriptive study. Association of scores obtained by students with their respective university, obtaining data from the Superintendency of Health page and using Microsoft Excel® software for processing. Results: The total number of graduates was 6,092, from 22 Chilean universities. The Pontificia Universidad Católica de Chile stands out for leading in item 1 and the total score during the 4 years and "Pedro de Valdivia" University for being in the last position. Items 4 and 5 were the most completed. The universities with the best performance in item 1 were also the ones that obtained the best performance in the final score. Discussion: Item 1 is the one that has the greatest importance in the final result of the contest and is not standardized among universities, being subject to the criteria of each institution. Not achieving the other items implies a comparative disadvantage as most participants have good scores, but these results are largely limited by grades.

Assessing social-emotional development in children from a longitudinal perspective.

This paper provides an overview of methodological challenges related to the epidemiological assessment of social-emotional development in children. Because population-based studies involve large cohorts and are usually multicentre in structure, they have cost, participant burden and other specific issues that affect the feasibility of the types of measures that can be administered. Despite these challenges, accurate in-depth assessment of social-emotional functioning is crucial, based on its importance to child outcomes like mental health, academic performance, delinquency and substance abuse. Five dimensions of social-emotional development in children are defined: (1) social competence; (2) attachment; (3) emotional competence; (4) self-perceived competence; and (5) temperament/personality. Their measurement in a longitudinal study and associated challenges are discussed. Means of making valid, reliable assessments while at the same time minimising the multiple challenges posed in the epidemiological assessment of social-emotional development in children are reviewed.

Assessment of neuropsychological trajectories in longitudinal population-based studies of children.

This paper provides a strategy for the assessment of brain function in longitudinal cohort studies of children. The proposed strategy invokes both domain-specific and omnibus intelligence test approaches. In order to minimise testing burden and practice effects, the cohort is divided into four groups with one-quarter tested at 6-monthly intervals in the 0-2-year age range (at ages 6 months, 1.0, 1.5 and 2.0 years) and at annual intervals from ages 3-20 (one-quarter of the children at age 3, another at age 4, etc). This strategy allows investigation of cognitive development and of the relationship between environmental influences and development at each age. It also allows introduction of new domains of function when age-appropriate. As far as possible, tests are used that will provide a rich source of both longitudinal and cross-sectional data. The testing strategy allows the introduction of novel tests and new domains as well as piloting of tests when the test burden is relatively light. In addition to the recommended tests for each age and domain, alternative tests are described. Assessment methodology and knowledge about child cognitive development will change over the next 20 years, and strategies are suggested for altering the proposed test schedule as appropriate.

Approaches to psychiatric assessment in epidemiological studies of children.

An assessment protocol for the longitudinal measurement of developmental psychopathology in a population-based study of children and adolescents is proposed. The protocol is designed for use in a large cohort of up to 100,000 individuals followed from early gestation to 21 years of age. Although the protocol was constrained by specified methodological parameters, the recommendations may apply to other psychiatric epidemiological research designs. The issues and challenges inherent with psychiatric assessments in longitudinal epidemiological studies of children and adolescents are discussed.

Proposed motor development assessment protocol for epidemiological studies in children.

This paper proposes an approach to the implementation of a large-scale epidemiological study of child development. It addresses specifically how one might assess gross motor development longitudinally in a large population-based study of children, and recommends a three-phase process. Phase I, applied at key ages with the entire population, involves the use of parent-report screening tools that ask about specific age-appropriate motor skills, as well as any parental concerns about "quantity" or "quality" of their child's motor function and about any loss of motor function. In phase II, children who "fail" the screening phase (at any stage) are evaluated with specified developmental motor assessments. Those who "pass" revert to the screening stream, while those who "fail" continue to phase III. In this third component of the study, children are referred to experts in child development formally engaged in the study (including developmental paediatricians, paediatric neurologists and developmental therapists). These experts will use protocol-based evaluations to ascertain whether a child has a problem in development, what the problem might be from a diagnostic perspective, how "severe" the problem is, and what management services are or should be provided. It is argued that this is an efficient approach to the study of a population that would enable investigators to detect specific relatively common developmental motor disorders (in particular, cerebral palsy and developmental coordination disorder).

Predictors of occupational exposure to styrene and styrene-7,8-oxide in the reinforced plastics industry.

OBJECTIVE: To identify demographic and work related factors that predict blood levels of styrene and styrene-7,8-oxide (SO) in the fibreglass reinforced plastics (FRP) industry. METHODS: Personal breathing-zone air samples and whole blood samples were collected repeatedly from 328 reinforced plastics workers in the Unuted States between 1996 and 1999. Styrene and its major metabolite SO were measured in these samples. Multivariable linear regression analyses were applied to the subject-specific levels to explain the variation in exposure and biomarker levels. RESULTS: Exposure levels of styrene were approximately 500-fold higher than those of SO. Exposure levels of styrene and SO varied greatly among the types of products manufactured, with an 11-fold range of median air levels among categories for styrene and a 23-fold range for SO. Even after stratification by job title, median exposures of styrene and SO among laminators varied 14- and 31-fold across product categories. Furthermore, the relative proportions of exposures to styrene and SO varied among product categories. Multivariable regression analyses explained 70% and 63% of the variation in air levels of styrene and SO, respectively, and 72% and 34% of the variation in blood levels of styrene and SO, respectively. Overall, air levels of styrene and SO appear to have decreased substantially in this industry over the last 10-20 years in the US and were greatest among workers with the least seniority. CONCLUSIONS: As levels of styrene and SO in air and blood varied among product categories in the FRP industry, use of job title as a surrogate for exposure can introduce unpredictable measurement errors and can confound the relation between exposure and health outcomes in epidemiology studies. Also, inverse relations between the intensity of exposure to styrene and SO and years on the job suggest that younger workers with little seniority are typically exposed to higher levels of styrene and SO than their coworkers.

Feeding mechanisms in two treefrogs, Hyla nana and Scinax nasicus (Anura: Hylidae).

After the description of the chondrocranium, hyobranchial apparatus, associated musculature, buccal apparatus, buccopharyngeal cavity, digestive tract, and gut contents, it was possible to define the feeding modes of Scinax nasicus and Hyla nana tadpoles (Gosner Stages 31-36). Scinax nasicus larvae are "typical" microphagous tadpoles, with keratodonts and robust rostrodonts appropriate for rasping surfaces and mincing of food particles; the buccopharyngeal cavity is equipped with filtering structures and has a conspicuous glandular zone and a highly developed branchial basket. In contrast, H. nana tadpoles have a modified buccal apparatus; the reduction of the buccopharyngeal and branchial basket structures, together with the high lever-arm ratio and the great development of the depressor muscles of the buccal floor are indicative of macrophagous feeding.

Temporal association between serum prolactin concentration and exposure to styrene.

BACKGROUND: Previous studies have suggested that occupational exposure to styrene is associated with increased serum levels of the anterior pituitary hormone prolactin (PRL). AIMS: To test the hypotheses that: (1) the effect of styrene exposure on PRL secretion is an acute effect, not a subchronic or chronic effect; (2) blood styrene, as a measure of absorbed dose, is a stronger predictor of serum PRL level than personal breathing zone air styrene concentration. METHODS: Subjects were recruited from 17 workplaces in the reinforced plastics industry. Personal breathing zone air styrene, whole blood styrene, and serum PRL were measured during one to three sessions, approximately one year apart. Linear multiple regression was used to model the relations between acute (air styrene or blood styrene obtained at same time as PRL), subchronic (average air or blood styrene over two or three sessions), and chronic (years of work in industry or facility times average air styrene over all sessions) indices of styrene exposure and serum PRL. RESULTS: Acute blood styrene concentration was the strongest predictor of serum PRL concentration, with the model predicting a 2.06-fold increase in PRL (95% CI 1.11 to 3.84) for every 10-fold increase in blood styrene. Serum PRL tended to increase with increasing styrene exposure in both men and women; however, women tended to have higher PRL levels. For women, the change in blood styrene between sessions 1 and 2 was a significant predictor of the change in serum PRL between sessions. CONCLUSIONS: Results confirm that styrene exposure enhances serum PRL concentrations and support an acute effect of styrene on PRL secretion.

Determination of styrene and styrene-7,8-oxide in human blood by gas chromatography-mass spectrometry.

Methods of isotope-dilution gas chromatography-mass spectrometry (GC-MS) are described for the determination of styrene and styrene-7,8-oxide (SO) in blood. Styrene and SO were directly measured in pentane extracts of blood from 35 reinforced plastics workers exposed to 4.7-97 ppm styrene. Using positive ion chemical ionization, styrene could be detected at levels greater than 2.5 microg/l blood and SO at levels greater than 0.05 microg/l blood. An alternative method for measurement of SO employed reaction with valine followed by derivatization with pentafluorophenyl isothiocyanate and analysis via negative ion chemical ionization GC-MS-MS (SO detection limit=0.025 microg/l blood). The detection limits for SO by these two methods were 10-20-fold lower than gas chromatographic assays reported earlier, based upon either electron impact MS or flame ionization detection. Excellent agreement between the two SO methods was observed for standard calibration curves while moderate to good agreement was observed among selected reinforced plastics workers (n = 10). Levels of styrene in blood were found to be proportional to the corresponding air exposures to styrene, in line with other published relationships. Although levels of SO in blood, measured by the direct method, were significantly correlated with air levels of either styrene or SO among the reinforced plastics workers, blood concentrations were much lower than previously reported at a given exposure to styrene. The two assays for SO in blood appear to be unbiased and to have sufficient sensitivity and specificity for applications involving workers exposed to styrene and SO during the manufacture of reinforced plastics.

Serum hepatic biochemical activity in two populations of workers exposed to styrene.

OBJECTIVE: To determine whether hepatic biochemical changes, as measured by routinely available tests indicative of hepatocellular necrosis, cholestasis, or altered hepatic clearance of bilirubin, occur in association with low to moderate exposure to styrene commonly experienced in industrial production. METHODS: Two independent cross sectional studies were performed comparing serum hepatic transaminases (alanine aminotransferase (ALT) and aspartate aminotransferase (AST)), cholestatic enzymes (alkaline phosphatase (AP) and gamma glutamyl transpeptidase (GGT)), and bilirubin in (a) 47 workers of fibreglass reinforced plastics who were exposed to styrene and (b) 21 boat and tank fabricators, with separate referent groups of unexposed workers. Exposure to styrene was assessed in air by dosimetry, and in venous blood by headspace analysis. Hepatic biochemical variables were assessed across strata of exposure to styrene defined as 25 ppm in air, or 0.275 mg/l in blood, adjusting for age, sex, body mass index, and ethanol consumption. RESULTS: A consistent and significant linear trend for increasing direct bilirubin and direct/total bilirubin ratio was found in association with increasing exposure to styrene, by both air and blood monitoring, in both studies. Mean direct bilirubin concentrations increased from 0.05-0.08 mg% in referents to 0.12-0.19 in workers exposed above 25 ppm, with a significant exposure-response trend (p<0.005). Significantly increased direct/total bilirubin ratios, ranging from 0.22 to 0.35 were associated with exposure to styrene (p<0.001), indicating diminished hepatic clearance of conjugated bilirubin. Also, a significant linear association between the hepatic transaminases ALT and AST and exposure to styrene was found in pooled regression analyses, with an increase in AP of about 10 IU/ml in workers exposed above 25 ppm air or 0.275 mg/l blood styrene in pooled analyses from both studies. CONCLUSIONS: The consistent finding of increased direct bilirubin and AP concentrations in these two independent studies provides evidence for diminished hepatic clearance of conjugated bilirubin with associated cholestasis in workers exposed to styrene. The finding of a significant linear association between hepatic transaminase concentrations and exposure to styrene in pooled analyses is consistent with mild hepatic injury and associated metabolic dysfunction.

Measurement of styrene-7,8-oxide and other oxidation products of styrene in air.

Styrene-7,8-oxide (SO) is generated at low concentrations from the oxidation of styrene during the processing of reinforced plastics. Since exposure to SO has important health implications, we developed air sampling and analytical methods to measure low levels of airborne SO in the presence of styrene and its other oxidation products, namely phenylacetaldehyde (PAA) and acetophenone (AP). Both active and passive air monitors were used. The active sampling method, which employed adsorption on Tenax, was suitable for measuring SO, PAA and AP but had limited capacity for styrene due to breakthrough. The passive monitor employed a carbon adsorbent and was suitable for measurement of styrene and SO but not PAA and AP due to poor recovery. After sampling, the analytes were extracted from the adsorbents with ethyl acetate and measured by gas chromatography with flame ionization detection or mass spectrometry. By maintaining the injection port at 70 degrees C, the thermal rearrangement of SO to PAA was minimized. Recovery of styrene and SO from the passive monitor depended upon loading and was corrected by linearization of the Freundlich isotherm. The limits of detection for SO, PAA, and AP were 0.2 ppb using the active monitor, and for SO was 1 ppb using the passive monitor. The sampling precision for SO (RSD from personal measurements) was 5.0% for the passive monitor and was 13.4% for the active monitor over a range of exposures from 5-150 ppb. The corresponding precision for styrene was 5.3% for the passive monitor for levels ranging from 1.2 to 104 ppm. Measurements of 235 personal exposures with the active monitor in 12 facilities manufacturing fiberglass-reinforced plastics (FRP) showed that levels of AP and PAA were below 7.8 ppb and 5 ppb, respectively. In contrast, SO averaged 30.4 ppb (SE=2.4) in these FRP facilities, ranging from below 0.2 ppb to 190 ppb. The active monitor was also used to detect airborne SO at levels of approximately equals 1 ppb in one facility manufacturing styrene butadiene rubber, suggesting that SO is generally present during the polymerization of styrene. Personal passive monitoring in the 12 FRP facilities (n = 657) revealed mean concentrations of styrene ranging between 1.8 and 55.4 ppm, and for SO between 1.7 and 62.6 ppb. The ratio of the mean styrene level to the mean SO level varied between 449:1 and 1,635:1 among the 12 FRP facilities.

Occupational exposure to electromagnetic fields and Alzheimer disease.

The association between occupational exposure to electromagnetic fields (EMF) and Alzheimer disease (AD) was examined. Subjects were identified from a large health maintenance organization in Seattle, Washington, and matched by age, sex, and proxy type. A complete occupational history was obtained from proxies and controls. Following the interview, two industrial hygienists (IHs) rated exposures to EMF for each job blinded to case-control status. Exposures to EMF were rated as probable intermittent exposure or probable exposure for extended periods to levels above threshold. Conditional logistic regression was used to calculate the risk of AD given EMF exposure stratified by IH. The odds ratios for ever having been exposed to EMF were 0.74 [95% confidence interval (CI) 0.29-1.92] and 0.95 (95% CI 0.27-2.43) for each IH, adjusting for age and education. No dose-response effect was noted. Agreement between the two IHs for ever having been exposed to EMF was good (kappa = 0.57, p < 0.0001). This study was unable to support an association between EMF and AD.

Occupational exposures to solvents and aluminium and estimated risk of Alzheimer's disease.

OBJECTIVES: To study the role of occupational exposures to solvents and aluminium in the aetiology of Alzheimer's disease (AD). An industrial hygienist rated exposure. METHODS: 89 subjects diagnosed with probable AD were matched by age, sex, and type of informant to 89 controls. Subjects were identified from a large health maintenance organisation in Seattle, WA. A complete occupational history was obtained from spouses of cases and controls as well as from controls themselves. After the interview an industrial hygienist, blinded to case-control status, rated exposures. RESULTS: Non-significant associations were found between AD and ever having been occupationally exposed to solvents (odds ratio (OR) 1.77, 95% confidence interval (95% CI) 0.81 to 3.90) and aluminium (OR 1.46, 95% CI 0.62 to 3.42). Although an increasing risk was found with increasing number of years of exposure to solvents, there was an inverse association between exposure intensity and AD, and measures of cumulative exposure taking into account both intensity and duration of exposure were not significant. Analysis of the age at which half the cumulative exposure to solvents was achieved showed that an older age incurred a greater risk of AD than a younger age. However, the total amount of exposure carried no risk. CONCLUSIONS: The results suggest that lifetime occupational exposure to solvents and aluminium are not likely to be important risk factors for Alzheimer's disease.

Behavioral effects of low-level exposure to Hg0 among dental professionals: a cross-study evaluation of psychomotor effects.

A Across-study design was used to evaluate the sensitivities of five psychomotor tasks previously used to assess preclinical effects of low-level Hg0 (urinary < or =55 microg/l). Pooling dental professional subject populations from six studies conducted over the last 6 years, a larger study population was obtained with a high degree of uniformity (N = 230). The five psychomotor tests were: Intentional Hand Steadiness Test (IHST); Finger Tapping: The One-Hole Test: NES Simple Reaction Time (SRT); and Hand Tremor. Multivariate analyses were conducted following the hierarchical analysis of multiple responses (HAMR) approach. First, multiple scores of each test were combined into a single-factor (or related summary) variable and its reliability was estimated. Second. multiple regression analyses were conducted including log-transformed [Hg0]U levels, age, gender, and alcohol consumption in each model. Computed were both B and bu, the magnitudes of the log-Hg0 standardized coefficient. respectively uncorrected and corrected for dependent variable attenuation due to unreliability. Results indicated remarkable differences in the effects of relative level of Hg0 on psychomotor performance. Significant associations were found for the IHST factor (B = 0.415, p < 10(-6)), followed by finger tapping, which was relatively meager and insignificant (B 0.141, p = 0.17). The IHST results hold the greatest occupational relevance for dental professionals who rely on manual dexterity in restorative dentistry. Further, this statistical approach is recommended in future studies for condensation of multiple scores into summary scores with enhanced reliabilities useful in correcting for attenuation relationships (B(u)s) with exposure levels.

Neurobehavioral effects from exposure to dental amalgam Hg(o): new distinctions between recent exposure and Hg body burden.

Potential toxicity from exposure to mercury vapor (Hg(o)) from dental amalgam fillings is the subject of current public health debate in many countries. We evaluated potential central nervous system (CNS) toxicity associated with handling Hg-containing amalgam materials among dental personnel with very low levels of Hg(o) exposure (i.e., urinary Hg <4 microg/l), applying a neurobehavioral test battery to evaluate CNS functions in relation to both recent exposure and Hg body burden. New distinctions between subtle preclinical effects on symptoms, mood, motor function, and cognition were found associated with Hg body burden as compared with those associated with recent exposure. The pattern of results, comparable to findings previously reported among subjects with urinary Hg >50 microg/l, presents convincing new evidence of adverse behavioral effects associated with low Hg(o) exposures within the range of that received by the general population.

Epidemiologic assessment of measures used to indicate low-level exposure to mercury vapor (Hg).

Mercury (Hg) concentrations in individual spot urine samples collected over consecutive 1-d periods were compared with Hg concentrations measured in combined 24-h urine samples from 69 practicing dental professionals with low exposure to Hg vapor (Hg) in order to validate the use of spot urine samples as an indicator of Hg exposure. The level of Hg in air as an exposure measure was also evaluated by comparing air concentrations of Hg in dental offices with both spot and 24-h urine Hg levels. The results showed: (1) There was little diurnal variation (approximately 9%) in urinary Hg values; (2) a strong correlation (R2 = .85) exists between the Hg concentration in the first morning void and that in a complete 24-h urine sample; (3) adjustment of urinary Hg levels for creatinine concentrations did not improve this correlation; (4) there was no added value in the speciation of total urinary Hg into the inorganic Hg fraction; and (5) concentrations of Hg in air did not significantly correlate with measures of Hg in urine at this low Hg exposure level. We conclude from this study that first morning void urine samples may be used to derive reasonably valid estimates of Hg concentrations found in the total amount of urine collected over a 24-h period. Thus, due to its comparability, ease of collection, and lower cost, the first morning urine void may be used in place of a sample collected over a full 24 h to facilitate Hg exposure assessments in epidemiologic studies that use urinary Hg levels as a measure of low-level Hg exposure.

Analyzing multivariate neurobehavioral outcomes in occupational studies: a comparison of approaches.

Neurobehavioral studies often employ test batteries and confront issues of multiple testing and comparability between batteries. We have organized our battery of 12 tests into areas of neurobehavioral function to reduce the number of reported results, provide greater statistical power, and improve interpretability of the results. We explored several different organizational and statistical methods of creating summary scores including a priori groupings based upon clinical experience and factor analysis. We compared the sensitivity of these summary scores to performance changes associated with exposure to styrene in the manufacture of reinforced plastics. Our results demonstrated dramatic increases in power to detect exposure related changes compared to using individual test scores. Furthermore, the various methods provided generally compatible and comparable results. We encourage other neurobehavioral investigators to pursue and refine this approach.