Linking Patient-Centered Outcomes to Neuropsychological Practice: A Conceptual Framework and Opportunities for Research.

In the current healthcare climate, reimbursement for services is increasingly linked to the ability to demonstrate beneficial patient outcomes. Neuropsychology faces some unique challenges in outcomes research, namely, that neuropsychologists often do not follow patients over time and the effect of neuropsychological services on patient outcomes may not be fully realized until under another provider's care. Yet there is an urgent need for empirical evidence linking neuropsychological practice to positive patient outcomes. To provide a framework for this research, we define a core set of patient-centered outcomes and neuropsychological processes that apply across practice settings and patient populations. Within each area, we review the available existing literature on neuropsychological outcomes, identifying substantial gaps in the literature for future research. This work will be critical for the field to demonstrate the benefit of neuropsychological services, to continue to advocate effectively for reimbursement, and to ensure high-quality patient care.

Test-retest reliability of the Advanced Psychodiagnostic Interpretation (API) scoring system for the Bender Gestalt in chronic schizophrenics.

This study assesses the test-retest reliability of the revised Advanced Psychodiagnostic Interpretation (API) scoring system for the Bender Gestalt Test (BGT). The API system identifies 207 possible distortions in a BGT protocol. Test-retest reliability for 40 schizophrenic patients tested twice with a mean interval of 6.4 years (SD=3.8 years) was good, ranging from .71 to .80. Further reliability and validity studies are needed to further demonstrate the effectiveness of the system.

Correlation of the LNNB-III with the WAIS-III in a mixed psychiatric and brain-injured population.

The purpose of the study was to examine the relationship between the Luria-Nebraska Neuropsychological Battery-Third Edition (LNNB-III) and the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). Participants were 85 adults referred for neuropsychological evaluation. The mean age of participants was 38.73 years (SD = 16.54) and average education was 13.07 years (SD = 2.60). The sample was predominantly female (52.9%), right-handed (86.3%), and Caucasian (68.6%), with the remainder of the population classified as Hispanic (13.7%), African-American (5.9%), or other (11.8%). Diagnoses included 26% psychiatric disorders, 64% neurological disorders, and 10% with no diagnosis. Pearson product correlation yielded a number of significant relationships between the WAIS-III IQ scores and the LNNB-III scales. The highest correlations were with the LNNB Intelligence, Visual-Spatial, Complex Auditory, and Arithmetic scales. Additionally, significant correlations were found between the WAIS-III subtests and a moderate proportion of the LNNB-III subtests. Correlations were also reported for the new WAIS-III scales, Letter-Number Sequencing and Matrix Reasoning. The results suggest that similar abilities are being assessed on both tests. These findings allow clinicians to not only evaluate the consistency of performance across this testing battery, but provide a useful screening instrument for intelligence.

Reliability of the Advanced Psychodiagnostic Interpretation (API) scoring system for the Bender Gestalt.

This study assesses the interrater reliability of the revised Advanced Psychodiagnostic Interpretation (API) scoring system for the Bender Gestalt Test (BGT). The API scoring system identifies 207 possible distortions in a BGT protocol. Agreement across nine raters exceeded 90% for each of three clinical protocols. Kappa statistics indicated that the API system exhibited good interrater reliability. Further research is necessary in such areas as test-retest reliability and validity to further demonstrate the effectiveness of the procedure.