Neuropsychological tests of the future: How do we get there from here?

Abstract

Objective: This article reviews current approaches to neuropsychological assessment, identifies opportunities for development of new methods using modern psychometric theory and advances in technology, and suggests a transition path that promotes application of novel methods without sacrificing validity.

Methods: Theoretical/state-of-the-art review.

Conclusions: Clinical neuropsychological assessment today does not reflect advances in neuroscience, modern psychometrics, or technology. Major opportunities for improving practice include both psychometric and technological strategies. Modern psychometric approaches including item response theory (IRT) enable linking procedures that can place different measures on common scales; adaptive testing algorithms that can dramatically increase efficiency of assessment; examination of differential item functioning (DIF) to detect measures that behave differently in different groups; and person fit statistics to detect aberrant patterns of responding of high value for performance validity testing. Opportunities to introduce novel technologies include computerized adaptive testing, Web-based assessment, healthcare- and bio-informatics strategies, mobile platforms, wearables, and the 'internet-of-things'. To overcome inertia in current practices, new methods must satisfy requirements for back-compatibility with legacy instrumentation, enabling us to leverage the wealth of validity data already accrued for classic procedures. A path to achieve these goals involves creation of a global network to aggregate item-level data into a shared repository that will enable modern psychometric analyses to refine existing methods, and serve as a platform to evolve novel assessment strategies, which over time can revolutionize neuropsychological assessment practices world-wide.

Keywords: Neuropsychology; clinical decision-making; diagnostic techniques and procedures; information science; psychological tests; psychometrics.