Validation of the cognitive section of the Penn computerized adaptive test for neurocognitive and clinical psychopathology assessment (CAT-CCNB).

BACKGROUND: The Penn Computerized Neurocognitive Battery is an efficient tool for assessing brain-behavior domains, and its efficiency was augmented via computerized adaptive testing (CAT). This battery requires validation in a separate sample to establish psychometric properties. METHODS: In a mixed community/clinical sample of N = 307 18-to-35-year-olds, we tested the relationships of the CAT tests with the full-form tests. We compared discriminability among recruitment groups (psychosis, mood, control) and examined how their scores relate to demographics. CAT-Full relationships were evaluated based on a minimum inter-test correlation of 0.70 or an inter-test correlation within at least 0.10 of the full-form correlation with a previous administration of the full battery. Differences in criterion relationships were tested via mixed models. RESULTS: Most tests (15/17) met the minimum criteria for replacing the full-form with the updated CAT version (mean r = 0.67; range = 0.53-0.80) when compared to relationships of the full-forms with previous administrations of the full-forms (mean r = 0.68; range = 0.50-0.85). Most (16/17) CAT-based relationships with diagnostics and other validity criteria were indistinguishable (interaction p > 0.05) from their full-form counterparts. CONCLUSIONS: The updated CNB shows psychometric properties acceptable for research. The full-forms of some tests should be retained due to insufficient time savings to justify the loss in precision.

When CAT is not an option: complementary methods of test abbreviation for neurocognitive batteries.

INTRODUCTION: There is an obvious need for efficient measurement of neuropsychiatric phenomena. A proven method-computerized adaptive testing (CAT)-is not feasible for all tests, necessitating alternatives for increasing test efficiency. METHODS: We combined/compared two methods for abbreviating rapid tests using two tests unamenable to CAT (a Continuous Performance Test [CPT] and n-back test [NBACK]). N=9,498 (mean age 14.2 years; 52% female) were administered the tests, and abbreviation was accomplished using methods answering two questions: what happens to measurement error as items are removed, and what happens to correlations with validity criteria as items are removed. The first was investigated using quasi-CAT simulation, while the second was investigated using bootstrapped confidence intervals around full-form-short-form comparisons. RESULTS: Results for the two methods overlapped, suggesting that the CPT could be abbreviated to 57% of original and NBACK could be abbreviated to 87% of original with the max-acceptable loss of precision and min-acceptable relationships with validity criteria. CONCLUSIONS: This method combination shows promise for use in other test types, and the divergent results for the CPT/NBACK demonstrate the methods' abilities to detect when a test should not be shortened. The methods should be used in combination because they emphasize complementary measurement qualities: precision/validity..

Construction of a computerized adaptive test (CAT-CCNB) for efficient neurocognitive and clinical psychopathology assessment.

BACKGROUND: Traditional paper-and-pencil neurocognitive evaluations and semi-structured mental health interviews can take hours to administer and score. Computerized assessment has decreased that burden substantially, and contemporary psychometric tools such as item response theory and computerized adaptive testing (CAT) allow even further abbreviation. NEW METHOD: The goal of this paper was to describe the application of CAT and related methods to the Penn Computerized Neurocognitive Battery (CNB) and a well-validated clinical assessment in order to increase efficiency in assessment and relevant domain coverage. To calibrate item banks for CAT, N = 5053 participants (63% female; mean age 45 years, range 18-80) were collected from across the United States via crowdsourcing, providing item parameters that were then linked to larger item banks and used in individual test construction. Tests not amenable to CAT were abbreviated using complementary short-form methods. RESULTS: The final "CAT-CCNB" battery comprised 21 cognitive tests (compared to 14 in the original) and five adaptive clinical scales (compared to 16 in the original). COMPARISON WITH EXISTING METHODS: This new battery, derived with contemporary psychometric approaches, provides further improvements over existing assessments that use collections of fixed-length tests developed for stand-alone administration. The CAT-CCNB provides an improved version of the CNB that shows promise as a maximally efficient tool for neuropsychiatric assessment. CONCLUSIONS: We anticipate CAT-CCNB will help satisfy the clear need for broad yet efficient measurement of cognitive and clinical domains, facilitating implementation of large-scale, "big science" approaches to data collection, and potential widespread clinical implementation.