Clinical Comparison of Two Confrontation Naming Measures in Spanish-Speaking People with Epilepsy.

OBJECTIVE: Research on the lateralizing value of neuropsychological tests is limited among Latino people with epilepsy (PWE). This study aims to evaluate the utility of two confrontation naming measures in laterality determination. METHOD: Data were collected from 71 Latino PWE who completed the Vocabulario Sobre Dibujos (VSD) and the Pontón-Satz Modified Boston Naming Test (MBNT). Raw and standardized scores were examined to determine diagnostic accuracy for predicting left hemisphere (LH) epilepsy for the full sample and using a sample-specific median split of educational attainment. RESULTS: The MBNT demonstrated adequate classification accuracy (65.7%, 77.1%) as did the VSD (54.3%, 74.3%) for predicting LH seizure laterality using raw and standardized scores, respectively. For participants with ≥ 9 years of education (HEdu), receiver operator characteristic curve analyses showed a raw/percentile cutoff of ≤ 26/≤ 5th on the VSD, yielding 53%-58% sensitivity/87%-83% specificity. A raw score cutoff of ≤ 17 on MBNT produced 47% sensitivity/78% specificity for HEdu participants. CONCLUSIONS: The VSD was found to have greater flexibility in determining cutoff scores using either raw or standardized scores for predicting seizure laterality. This study provides interpretation guidance, emphasizing education as a pertinent variable, to optimize lateralization accuracy for Latino PWE.

Measurement properties of the CLOX Executive Clock Drawing Task in an inpatient stroke rehabilitation setting.

OBJECTIVES: The goal of this study was to explore the psychometric properties of the CLOX Executive Clock Drawing Task (Royall, Cordes, & Polk, 1998) in persons who had sustained a stroke and were receiving inpatient rehabilitation. METHOD: Rasch modeling was utilized to examine the psychometric properties of the CLOX. Separate analyses were conducted for the free draw (CLOX 1) and copy (CLOX 2) portions of the measure to investigate each presentation mode independently. The sample consisted of 66 inpatient adults who had sustained a stroke. RESULTS: CLOX 1 met most Rasch model expectations for item fit, unidimensionality, test reliability, and sample targeting. CLOX 2 was less psychometrically sound and contained two items with significant misfit. CLOX 2 demonstrated a significant ceiling effect that resulted in poor sample targeting. CONCLUSIONS: CLOX 1 is a psychometrically sound screening instrument for assessing persons with stroke receiving inpatient rehabilitation. In addition to the psychometric weaknesses of CLOX 2, its interpretive yield is minimal and clinicians may consider omitting it. Recommendations are made for using the Rasch item-person maps in clinical practice.