Integrating Technology in Neuropsychological Assessment
A Narrative Review of the Main Obstacles, New Developments, and Potential Issues in Assessment Through Tablets
Abstract
Abstract. Although neuropsychological assessments include some measures that are administered, scored, or interpreted using new technologies, most researchers in this area advocate that more technology should be integrated. The current situation in neuropsychological assessment may be conceptualized as triggering a crisis leading to a paradigm shift, as there is some resistance to adopting more technology. In this paper, the context of the present crisis in neuropsychological assessment, the main obstacles, and new developments will be discussed. An example of a new computerized assessment tool, the NIH Toolbox, is highlighted. Also addressed are potential issues: in the assessment with tablets illustrating it with the older adult population and how to ensure the compatibility of data collected through these devices within the framework of the European General Data Protection Regulation (GDPR). Recommendations for research, test development, and clinical practice are also provided.
References
2020). Towards a European health research and innovation cloud (HRIC). Genome Medicine, 12(1), 18. https://doi.org/10.1186/s13073-020-0713-z
(2018, September 7). Práticas de avaliação psicológica em Portugal: Resultados gerais de inquérito realizado sobre a utilização de testes e outros instrumentos
([Practice of psychological assessment in Portugal: General results of the survey on the use of tests and other instruments] . Abstract communication, Proceedings of the 10th Congress AIDAP/AIDEP: Diagnóstico e Avaliação psicológica [Psychological Diagnosis and Assessment], Coimbra, Portugal.2017). Profession of neuropsychology in Latin America. Applied Neuropsychology: Adult, 24(4), 318–330. https://doi.org/10.1080/23279095.2016.1185423
(2019). SANRA – A scale for the quality assessment of narrative review articles. Research Integrity and Peer Review, 4, Article
(5 . https://doi.org/10.1186/s41073-019-0064-82020). Artificial intelligence and neuropsychological measures: The case of Alzheimer’s disease. Neuroscience & Biobehavioral Reviews, 114, 211–228. https://doi.org/10.1016/j.neubiorev.2020.04.026
(2012). Computerized neuropsychological assessment devices: Joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology. Archives of Clinical Neuropsychology, 27(3), 362–373. https://doi.org/10.1093/arclin/acs027
(2011). Neuropsychology 3.0: Evidence-based science and practice. Journal of the International Neuropsychological Society, 17(1), 7–13. https://doi.org/10.1017/S1355617710001396
(2019). Neuropsychological tests of the future: How do we get there from here? The Clinical Neuropsychologist, 33(2), 220–245. https://doi.org/10.1080/13854046.2018.1521993
(2013). What is the NIH Toolbox, and what will it mean to neurology? Neurology, 80(10), 874–875. https://doi.org/10.1212/WNL.0b013e3182872ea0
(2014). Computerized neuropsychological assessment in aging: Testing efficacy and clinical ecology of different interfaces. Computational and Mathematical Methods in Medicine, 2014, 1–13. https://doi.org/10.1155/2014/804723
(2016). Password security: An analysis of password strengths and vulnerabilities. International Journal of Computer Network and Information Security, 8(7), 23–30. https://doi.org/10.5815/ijcnis.2016.07.04
(2014). Big data, open science and the brain: Lessons learned from genomics. Frontiers in Human Neuroscience, 8, Article
(239 . https://doi.org/10.3389/fnhum.2014.002392017). Back to the future of quantitative psychology and measurement: Psychometrics in the twenty-first century. Frontiers in Psychology, 8, Article
(2099 . https://doi.org/10.3389/fpsyg.2017.020992019). Why and how we should care about the General Data Protection Regulation. Psychology & Health, 34(11), 1347–1357. https://doi.org/10.1080/08870446.2019.1606222
(2015). Integration of computers in cognitive assessment and level of comprehensiveness of frequently used computerized batteries. Neurology, Psychiatry and Brain Research, 21(3), 128–135. https://doi.org/10.1016/j.npbr.2015.07.003
(2019). Contributing towards a cultural neuropsychology assessment decision-making framework: Comparison of WAIS-IV norms from Colombia, Chile, Mexico, Spain, United States, and Canada. Archives of Clinical Neuropsychology, 34(5), 657–681. https://doi.org/10.1093/arclin/acy074
(2014). Alternative measurement paradigms for measuring executive functions: SEM (Formative and Reflective Models) and IRT (Rasch Models). Measurement: Interdisciplinary Research and Perspectives, 12, 102–108. https://doi.org/10.1080/15366367.2014.943592
(2016). General Data Protection Regulation [GDPR] Regulation (EU) 2016/679. https://eur-lex.europa.eu/legal-content/EN/ALL/?uri=CELEX:32016R0679
. (2020). COMMUNICATION: Data protection as a pillar of citizens’ empowerment and the EU’s approach to the digital transition: Two years of application of the General Data Protection Regulation COM/2020/264 final. https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52020DC0264&from=EN
. (2021). Reliability and validity of the Spanish-language version of the NIH toolbox. Assessment, 28(2), 457–471. https://doi.org/10.1177/1073191120913943
(2017). Electronic devices for cognitive impairment screening: A systematic literature review. International Journal of Technology Assessment in Health Care, 33(6), 654–673. https://doi.org/10.1017/S0266462317000800
(2010). Assessment of neurological and behavioural function: The NIH Toolbox. The Lancet Neurology, 9(2), 138–139. https://doi.org/10.1016/S1474-4422(09)70335-7
(2013). NIH Toolbox for assessment of neurological and behavioral function. Neurology, 80(11 Supplement 3), S2–S6. https://doi.org/10.1212/WNL.0b013e3182872e5f
(2018). Can psychology walk the walk of open science? American Psychologist, 73(2), 126–137. https://doi.org/10.1037/amp0000197
(2019). The European Union general data protection regulation: What it is and what it means. Information & Communications Technology Law, 28(1), 65–98. https://doi.org/10.1080/13600834.2019.1573501
(2020). Human brain project. https://www.humanbrainproject.eu/en/
. (2019). The impact of technology on psychological testing in practice and policy: What will the future bring. European Journal of Psychological Assessment, 35(2), 151–155. https://doi.org/10.1027/1015-5759/a000532
(2016). Administering cognitive tests through touch screen tablet devices: Potential issues. Journal of Alzheimer’s Disease, 54(3), 1169–1182. https://doi.org/10.3233/JAD-160545
(2016). Big science, team science, and open science for neuroscience. Neuron, 92(3), 612–616. https://doi.org/10.1016/j.neuron.2016.10.019
(1962). The structure of scientific revolutions. University of Chicago Press.
(2022). Utility of machine learning approach with neuropsychological tests in predicting functional impairment of alzheimer’s disease. Journal of Alzheimer’s Disease, 85(3), 1357–1372. https://doi.org/10.3233/JAD-215244
(2012). Neuropsychological assessment (5th ed.). Oxford University Press.
(2018). Computerized cognitive tests (CCT) in elderly: A psychometric review. Revue Européenne de Psychologie Appliquée, 68(2), 61–68. https://doi.org/10.1016/j.erap.2018.04.002
(2015). Neuropsychologists’ validity testing beliefs and practices: A survey of North American professionals. The Clinical Neuropsychologist, 29(6), 741–776. https://doi.org/10.1080/13854046.2015.1087597
(2019). Are requirements to deposit data in research repositories compatible with the European Union’s General Data Protection Regulation? Annals of Internal Medicine, 170(5), 332–334. https://doi.org/10.7326/M18-2854
(2017). Technologies to support community-dwelling persons with dementia: A position paper on issues regarding development, usability, effectiveness and cost-effectiveness, deployment, and ethics. JMIR Rehabilitation and Assistive Technologies, 4(1), Article
(e1 . https://doi.org/10.2196/rehab.63762019). Big data and biomedical informatics: Preparing for the modernization of clinical neuropsychology. The Clinical Neuropsychologist, 33(2), 287–304. https://doi.org/10.1080/13854046.2018.1523466
(2018). Artificial intelligence in medical practice: The question to the answer? The American Journal of Medicine, 131(2), 129–133. https://doi.org/10.1016/j.amjmed.2017.10.035
(2017). The technology crisis in neuropsychology. Archives of Clinical Neuropsychology, 32(5), 541–554. https://doi.org/10.1093/arclin/acx050
(2017). From individual to group privacy in big data analytics. Philosophy & Technology, 30, 475–494. https://doi.org/10.1007/s13347-017-0253-7
(2019). Health apps, their privacy policies and the GDPR. European Journal of Law and Technology, 10(1). https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3506805
(2020). The brain initiative. NIH. https://braininitiative.nih.gov/
. (2016). NIH Toolbox® scoring and interpretation guide [Manual]. http://assistly-production.s3.amazonaws.com/228622/kb_article_attachments/98102/Toolbox_Scoring_and_Interpretation_Guide_for_iPad_v1.7_original.pdf?AWSAccessKeyId=AKIAJNSFWOZ6ZS23BMKQ&Expires=1531157325&Signature=F9GRT8bn%2Bsbijcg62zP%2Fcm1vuvQ%3D&response-content-disposition=filename%3D%22Toolbox_Scoring_and_Interpretation_Guide_for_iPad_v1.7.pdf%22&response-content-type=application%2Fpdf
. (2020, November). Hardware requirements: iPad/iOS. https://nihtoolbox.force.com/s/article/hardware-requirements-ipadios
. (2019). Artificial intelligence transforms the future of healthcare. The American Journal of Medicine, 132(7), 795–801. https://doi.org/10.1016/j.amjmed.2019.01.017
(2016). The profession of neuropsychology in Spain: Results of a national survey. The Clinical Neuropsychologist, 30(8), 1335–1355. https://doi.org/10.1080/13854046.2016.1183049
(2014). Resultados do censo dos membros efectivos da OPP
. ([Results of the full members census of the OPP] . OPP. https://www.ordemdospsicologos.pt/pt/noticia/12462013). Applications of technology in neuropsychological assessment. The Clinical Neuropsychologist, 27(8), 1328–1361. https://doi.org/10.1080/13854046.2013.834971
(2018). Practice parameters facilitating adoption of advanced technologies for enhancing neuropsychological assessment paradigms. The Clinical Neuropsychologist, 32(1), 16–41. https://doi.org/10.1080/13854046.2017.1337932
(2018). The revolution of personalized psychiatry: Will technology make it happen sooner? Psychological Medicine, 48(5), 705–713. https://doi.org/10.1017/S0033291717002859
(2022a). Q-interactive. https://www.pearsonassessments.com/professional-assessments/digital-solutions/q-interactive/about.html
. (2022b). Q-interactive France. https://www.pearsonclinical.fr/evaluation-numerique/q-interactive
. (2022c). Q-GLOBAL. https://www.pearsonclinical.es/digital/evaluacion-online
. (2017). Neuropsychological testing in professional psychology specialties: Summary findings of 36 studies (1990–2016) in applied settings. Journal of the Indian Academy of Applied Psychology, 43(1), 134–144.
(2019). Privacy in the age of medical big data. Nature Medicine, 25(1), 37–43. https://doi.org/10.1038/s41591-018-0272-7
(2009). Scoring neuropsychological tests using the Rasch model: An illustrative example with the Rey-Osterrieth Complex Figure. The Clinical Neuropsychologist, 24(1), 45–56. https://doi.org/10.1080/13854040903074645
(2018). Use of neuropsychological tests for the diagnosis of dementia: A survey of Italian memory clinics. BMJ Open, 8(3), Article
(e017847 . https://doi.org/10.1136/bmjopen-2017-0178472016). Stability in test-usage practices of clinical neuropsychologists in the United States and Canada over a 10-year period: A follow-up survey of INS and NAN members. Archives of Clinical Neuropsychology, 31(3), 206–230. https://doi.org/10.1093/arclin/acw007
(2014). Utilization rates of computerized tests and test batteries among clinical neuropsychologists in the United States and Canada. Professional Psychology: Research and Practice, 45(5), 368–377. https://doi.org/10.1037/a0037987
(2019). The use of tablet technology by older adults in health care settings – Is it effective and satisfying? A systematic review and meta analysis. Clinical Gerontologist, 42(1), 17–26. https://doi.org/10.1080/07317115.2017.1322162
(2018). Patient perspectives of the experience of a computerized cognitive assessment in a clinical setting. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 4, 297–303. https://doi.org/10.1016/j.trci.2018.06.003
(2019). Why are neuropsychologists so reluctant to embrace modern assessment techniques? The Clinical Neuropsychologist, 33(2), 209–219. https://doi.org/10.1080/13854046.2018.1523468
(2019). Testes psicológicos em Portugal: Atitudes, problemas e perfil dos utilizadores [Psychological tests in Portugal: Attitudes, problems and user profiles]. Revista Iberoamericana de Diagnóstico y Evaluación Psicológica, 4(53), 101–112. https://doi.org/10.21865/RIDEP53.4.08
(2020). Tablet-administered screening tests for the detection of major and mild cognitive disorders: Preliminary findings of a comparative study. International Journal of Interactive Mobile Technologies, 14(11), 200–223. https://doi.org/10.3991/ijim.v14i11.14629
(2010). The value of item response theory in clinical assessment: A review. Assessment, 18(3), 291–307. https://doi.org/10.1177/1073191110374797
(2004). The multi-item localization (MILO) task: Measuring the spatiotemporal context of vision for action. Perception & Psychophysics, 66(1), 38–50. https://doi.org/10.3758/BF03194859
(2008). The status of computerized cognitive testing in aging: A systematic review. Alzheimer’s & Dementia: the Journal of the Alzheimer’s Association, 4(6), 428–437. https://doi.org/10.1016/j.jalz.2008.07.003
(2017). Choosing prediction over explanation in psychology: Lessons from machine learning. Perspectives on Psychological Science, 12(6), 1100–1122. https://doi.org/10.1177/1745691617693393
(2019). Encouraging users to improve password security and memorability. International Journal of Information Security, 18(6), 741–759. https://doi.org/10.1007/s10207-019-00429-y
(2016). An application of item response theory to psychological test development. Psicologia: Reflexão e Crítica, 29(1), 1–10. https://doi.org/10.1186/s41155-016-0040-x
(2015). Computerized cognitive testing for older adults: A review. American Journal of Alzheimer’s Disease & Other Dementias, 30(1), 13–28. https://doi.org/10.1177/1533317514522852
(