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The accuracy of automated and clinical detection of brain damage and lateralization in neuropsychology

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Abstract

The validity of both computer programs and clinical judgment in neuropsychology for determining the existence and lateralization of brain damage is reviewed. Computerized interpretation in neuropsychology, after a propitious beginning, was largely abandoned due to severe criticism, essentially based on only three studies. Only one of these studies compared clinical judgment with computer programs. A thorough examination of the literature located many more studies assessing the accuracy of computer programs, clinical judgment, and discriminant analysis. When reviewed, these studies found that the computer programs, especially the Neuropsychological Key, were quite accurate though not as accurate as clinical judgment. Computer programs and especially the Lateralization Index are potentially as accurate as expert clinical judgment. The rationale related to computer programs is also discussed. This includes the implications of impairment, criterion adequacy, and methods used in designing the neuropsychological Key and the Lateralization Index. Since computer programs are completely reliable across studies, they can be used to examine the differences between sample populations and criterion accuracy. Factors contributing to reduced accuracy in both clinical judgment and computer programs are also explicated.

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References

  • Adams, K. M. (1975). Automated clinical interpretation of the neuropsychological test battery: An ability based approach. Dissertation Abstracts International, 35, 6085B (University Microfilms No. 75-13, 289).

  • Adams, K. M. (1986). Concepts and methods in the design of automata for the neuropsychological test interpretation. In Filskov, S. B., and Boll, T. J. (eds.),Handbook of Clinical Neuropsychology, John Wiley & Sons, New York, pp. 561–575.

    Google Scholar 

  • Adams, K. M., and Brown, G. G. (1986). The role of the computer in neuropsychological assessment. In Grant, I. and Adams, K. M. (eds.),Neuropsychological Assessment of Neuropsychiatric Disorders, Oxford University Press, New York, pp. 87–99.

    Google Scholar 

  • Adams, K. M., and Heaton, R. K. (1985). Automated interpretation of neuropsychological test data.Journal of Consulting and Clinical Psychology 53: 790–802.

    PubMed  Google Scholar 

  • Adams, K. M., and Heaton, R. K. (1987). Computerized neuropsychological assessment: Issues and applications. In J. N. Butcher, J. N. (ed.),Computerized Psychological Assessment, New York, Basic Books, pp. 355–365.

    Google Scholar 

  • Adams, K. M., Kvale, V. I., and Keegan, J. F. (1984). Relative accuracy of three automated systems for neuropsychological interpretation.Journal of Clinical Neuropsychology, 6: 413–431.

    PubMed  Google Scholar 

  • Anthony, W. Z., Heaton, R. K., and Lehman, R. A. W. (1980). An attempt to cross-validate two actuarial systems for neuropsychological test interpretation.Journal of Consulting and Clinical Psychology, 48: 317–326.

    PubMed  Google Scholar 

  • Bak, J. S., and Greene, R. L. (1980). Changes in neuropsychological functioning in an aging population.Journal of Consulting and Clinical Psychology 48: 395–399.

    PubMed  Google Scholar 

  • Barron, J. H., and Russell, E. W. (1992). Fluidity theory and the neurospsychological impairment in alcoholism.Archives of Clinical Neuropsychology 7: 175–188.

    PubMed  Google Scholar 

  • Bernard, L. C. (1988).Eclectic Neuro Score (ENS) [computer program], Version 2. Loyola Marymount University, Loyola Boulevard & 80th Street, Los Angeles, CA.

    Google Scholar 

  • Bornstein, R. A. (1985). Normative data on selected neuropsychological measures from a nonclinical sample.Journal of Clinical Psychology 41: 651–659.

    Google Scholar 

  • Boyar, J. I., and Tsushima, W. T. (1975). Cross-validation of the Halstead-Reitan Neuropsychological Battery: Application in Hawaii.Hawaii Medical Journal 34: 94–96.

    PubMed  Google Scholar 

  • Butcher, J. N. (Ed.). (1987).Computerized Psychological Assessment, Basic Books, New York.

    Google Scholar 

  • Butters, N., Delis, D. C. and Lucas, J. A. (1995). Clinical assessment of memory disorders in amnesia and dementia.Annual Review of Psychology 46: 493–523.

    PubMed  Google Scholar 

  • Dobbins, C., and Russell, E. W. (1990). Left temporal lobe damage pattern on the Wechsler Adult Intelligence Scale.Journal of Clinical Psychology 46: 863–868.

    PubMed  Google Scholar 

  • Dodrill, C. B. (1988).What constitutes normal performance in clinical neuropsychology? Paper presented at the 97th Annual Convention of the American Psychological Association, Atlanta, GA.

  • Ellis R. J., and Oscar-Berman, M. (1989). Alcoholism, aging and functional cerebral asymmetries.Psychological Bulletin 106: 128–147.

    PubMed  Google Scholar 

  • EsData. (1984).Halstead-Reitan Neuropsychological Battery Software [Computer program]. Youngstown OH: EsData, Integrated Professional Systems, Inc., No. 1207.

    Google Scholar 

  • Faust, D. (1984).The Limits of Scientific Reasoning, University of Minnesota Press, Minneapolis, Minnesota.

    Google Scholar 

  • Faust, D., Guilmette, T. J., Hart, K., Arkes, H. R., Fishburne, F. J., and Davey, L. (1988a). Neuropsychologists' training, experience, and judgment accuracy.Archives of Clinical Neuropsychology 3: 145–163.

    PubMed  Google Scholar 

  • Faust, D., Ziskin, J., and Hiers, J. B. (1988b).Brain Damage Claims: Coping with Neuropsychological Evidence (Vol. 1), Law and Psychology Press, Los Angeles, pp. 186–188.

    Google Scholar 

  • Fields, F. R. J. (1987). Brain dysfunction: Relative discrimination accuracy of Halstead-Reitan and Luria-Nebraska Neuropsychological test batteries.Neuropsychology 1: 9–12.

    Google Scholar 

  • Filskov, S. B., and Goldstein, S. G. (1974). Diagnostic validity of the Halstead-Reitan Neuropsychological Battery.Journal of Consulting and Clinical Psychology 42: 382–388.

    PubMed  Google Scholar 

  • Finkelstein, J. N. (1977). BRAIN: A computer program for interpretation of the Halstead-Reitan Neuropsychological Test Battery.Dissertation Abstracts International. 37, B (University Microfilms No. 77-8, 8864).

  • Fromm-Auch, D., and Yeudall, L. T. (1983). Normative data for the Halstead-Reitan neuropsychological tests.Journal of Clinical Neuropsychology 5: 221–238.

    PubMed  Google Scholar 

  • Gade, A., and Mortensen, E. L. (1984, December).The influence of age, education, and intelligence on neuropsychological test performance. Paper presented at the 3rd Nordic Conference in Behavioral Toxicology, Arhus, Denmark.

  • Gade, A., Mortensen, E. L., Udesen, H., and Jonsson, A. (1985, June).Predictors of cognitive performance: Age, education, and intelligence. Paper presented at the 8th INS European Conference, Copenhagen, Denmark.

  • Golden, C. (1977). Validity of the Halstead-Reitan Neuropsychological Battery in a mixed psychiatric and brain-Injured population.Journal of Consulting and Clinical Psychology 43: 1043–1051.

    Google Scholar 

  • Golden, J. G. (1987). Computers in neuropsychology. In Butcher, J. N. (ed.),Computerized psychological Assessment, Basic Books, New York, pp. 344–354.

    Google Scholar 

  • Halstead, W. C. (1947).Brain and Intelligence, University of Chicago Press, Chicago.

    Google Scholar 

  • Goldstein, G. (1986). The neuropsychology of schizophrenia. In I. Grant, I. and Adams, K. M. (eds.),Neuropsychological Assessment of Neuropsychiatric Disorders, Oxford University Press, New York, pp. 147–171.

    Google Scholar 

  • Goldstein, G. (1987). Etiological considerations regarding the neuropsychological consequences of alcoholism. In Parsons, O. A., Butters, N., and Nathan, P. E. (eds.),Neuropsychology of Alcoholism, Gilford Press, New York.

    Google Scholar 

  • Goldstein, G., and Shelly, C. H. (1972). Statistical and normative studies of the Halstead Neuropsychological Test Battery relevant to a neuropsychiatric setting.Perceptual and Motor Skills 34: 603–620.

    PubMed  Google Scholar 

  • Goldstein, G., and Shelly, C. (1982a). A further attempt to cross-validate the Russell, Neuringer, and Goldstein Neuropsychological Keys.Journal of Consulting and Clinical Psychology 50: 721–726.

    PubMed  Google Scholar 

  • Goldstein, G., and Shelly, C. (1982b). A multivariate neuropsychological approach to brain lesion localization in alcoholism.Addictive Behaviors 7: 165–175.

    PubMed  Google Scholar 

  • Goldstein, S. G., Deysach, R. E., and Kleinknecht, R. A. (1973). Effect of experience and amount of information on identification of cerebral impairment.Journal of Consulting and Clinical Psychology 41: 30–34.

    PubMed  Google Scholar 

  • Guilford, J. P. (1965).Fundamental Statistics in Psychology and Education (4th ed.), McGraw-Hill, New York.

    Google Scholar 

  • Halstead, W. C. (1947).Brain and Intelligence. University of Chicago Press, Chicago.

    Google Scholar 

  • Heaton, R. K., and Adams, K.M. (1987). Potential versus current reality of automation in neuropsychology: Reply to Kleinmuntz.Journal of Consulting and Clinical Psychology 55: 268–269.

    Google Scholar 

  • Heaton, R. K., Grant, I., Anthony, W. Z., and Lehman, A. W. (1981). A comparison of clinical and automated interpretation of the Halstead-Reitan Battery.Journal of Clinical Neuropsychology 3: 121–141.

    PubMed  Google Scholar 

  • Heaton, R. K., Grant, I., and Matthews, C. G. (1991).Comprehensive Norms for an Expanded Halstead-Reitan Battery, Psychological Assessment Resources, Odessa, FL.

    Google Scholar 

  • Heaton, R. K., Grant, I., and Matthews, C. G. (1986). Differences in neuropsychological test performance associated with age, education and sex. In Grant, I., and Adams, K. M. (eds.),Neuropsychological Assessment of Neuropsychiatric Disorders, Oxford, New York, pp. 100–120.

    Google Scholar 

  • Honaker, L. M., and Fowler, R. D. (1990). Computer-assisted pychological assessment. In Goldstein, G. and Hersen, M. (eds.),Handbook of Psychological Assessment, Pergamon, New York, pp. 521–546.

    Google Scholar 

  • Huberty, C. J. (1984). Issues in the use and interpretation of discriminant analysis.Psychologicla Bulletin 95: 156–171.

    Google Scholar 

  • Incagnoli, T. (1986). Current directions and future trends in clinical neuropsychology. In Incagnoli, T. Goldstein, G., and Golden, C. G. (eds.),Clinical Application of Neuropsychological Test Batteries, pp. 1–44. Plenum, New York, pp. 1–44.

    Google Scholar 

  • Kane, R. L., and Kay, G. G. (1992). Computerized assessment in neuropsychology: A review of tests and test batteries.Neuropsychology Review 3: 1–117.

    PubMed  Google Scholar 

  • Kane, R. L., Sweet, J. J., Golden, C. J., Parsons, O. A., and Moses, J. A. (1981). Comparative diagnostic accuracy of the Halstead-Reitan and Standardized Luria-Nebraska Neuropsychological batteries in a mixed psychiatric and brain-damaged population.Journal of Consulting and Clinical Psychology 49: 484–485.

    PubMed  Google Scholar 

  • Kleinmuntz, B. (1987). Automated interpretation of neuropsychological test data: Comments on Adams and Heaton.Journal of Consulting and Clinical Psychology 55: 266–267.

    Google Scholar 

  • Knights, R. (1973). Problems of criteria in diagnosis: A profile similarity approach.Annuals of the New York Academy of Science 205: 124–131.

    Google Scholar 

  • Lezak, M. D. (1983).Neuropsychological Assessment (2nd ed.), Oxford, New York.

    Google Scholar 

  • Long, C. J., and Wagner, M. (1986). Computer applications in neuropsychology. In Wedding, D., Horton, A. M., and Webster, J. (eds.),The Neuropsychology Handbook, Springer, New York, pp. 548–569.

    Google Scholar 

  • Lynch, W. (1988). Computers in neuropsychological assessment.Journal of Head Trauma and Rehabilitation 3: 92–94.

    Google Scholar 

  • Martin, A., Brouwers, P., Lalonde, F., Cox, C., Teleska, P., Fedio, P., Foster, N. L., and Chase, T. N. (1986). Towards a behavioral typology of Alzheimer's patients.Journal of Consulting and Experimental Neuropsychology 8: 594–610.

    Google Scholar 

  • Matarazzo, J. D. (1990). Psychological assessment versus psychological testing, Validation from Binet to the school, clinic, and courtroom.American Psychologist 45: 99–1017.

    Google Scholar 

  • McCaffrey, R. J. and Lynch, J. K. (1993). A methodological review of “method skeptic” reports.Neuropsychology Review 3: 235–248.

    Google Scholar 

  • McSweeny, A. J., and Swiercinsky, D. P. (1985). Computer based neuropsychological test administration: Convergent and discriminant validity of the SAINT [abstract].Journal of Clinical and Experimental Neuropsychology, 7: 629.

    Google Scholar 

  • Meehl, P. E. (1954).Clinical versus Statistical Prediction: A Theoretical Analysis and a Review of the Evidence, University of Minnesota Press, Minneapolis.

    Google Scholar 

  • Mutchnick, M., Ross, L. K., and Long, C. J. (1991). Decision strategies for cerebral dysfunction IV: Determination of cerebral dysfunction.Archives of Clinical Neuropsychology 6: 259–270.

    PubMed  Google Scholar 

  • Netter, F. H., Jones, H. R., and Dingle, R. V. (1985).The Ciba Collection of Medical Illustrations, Ciba, West Caldwell, NJ.

    Google Scholar 

  • Pauker, J. D. (1977).Adult norms for the Halstead-Reitan neuropsychological test battery: Preliminary data. Paper presented at the Annual Meeting of the International Neuropsychological Society, Santa Fe, NM.

  • Prigatano, G. P., and Parsons, O. A. (1976). Relationship of age and education to Halstead Test Performance in different patient populations.Journal of Consulting and Clinical Psychology 44: 527–533.

    PubMed  Google Scholar 

  • Reitan, R. M. (1955a). An investigation of the validity of Halstead's measures of biological intelligence.Archives of Neurology and Psychiatry 73: 28–35.

    Google Scholar 

  • Reitan, R. M. (1955b). The distribution according to age of a psychologic measure dependent upon organic brain functions.Journal of Gerontology 10: 338–340.

    PubMed  Google Scholar 

  • Reitan, R. M. (1964). Psychological deficits resulting from cerebral lesions in men. In Warren, J. M., and Akert, K. (eds.),The Frontal Granular Cortex and Behavior, McGraw-Hill, New York, pp. 295–312.

    Google Scholar 

  • Reitan, R. M. (1991).The Neuropsychological Deficit Scale for adults computer program, Users Manual, Neuropsychology Press, Tucson, AZ.

    Google Scholar 

  • Reitan, R. M., and Wolfson, D. (1985).The Halstead-Reitan Neuropsychological Test Battery; Theory and Clinical Interpretation. Neuropsychology Press, Tucson, AZ.

    Google Scholar 

  • Reitan, R. M., and Wolfson, D. (1986). The Halstead-Reitan Neuropsychological Test Battery. In Wedding, D., Horton, A. M., Webster, J. (Eds.),The Neuropsychology Handbook. Springer, New York, pp. 134–160.

    Google Scholar 

  • Reitan, R. M., and Wolfson, D. (1988).Traumatic Brain Injury: Vol. 2. Recovery and Rehabilitation. Neuropsychology Press, Tucson, AZ.

    Google Scholar 

  • Retzlaff, P. D., and Gibertini, M. (1994) Neuropsychometric issues and problems. In Vanderploeg, R. D. (ed.),A Guide to Neuropsychological Practice, Erlbaum, Hillsdale, NJ, pp. 185–210.

    Google Scholar 

  • Robbins, D. E. (1989). The Halstead-Reitan Neuropsychological Battery. In Franzen, M. D. (ed.),Reliability and Validity in Neuropsychological Assessment, Plenum, New York, pp. 91–107.

    Google Scholar 

  • Rojas, D. C., and Bennett, T. L. (1995). Single versus composit score discriminative validity with the Halstead-Reitan Battery and the Stroop Test in mild brain injury.Archives of Clinical Neuropsychology 10: 101–110.

    PubMed  Google Scholar 

  • Ross, L., Thrasher, M., and Long, C. J. (1990). Decision strategies in neuropsychology I: Determination of lateralized cerebral dysfunction.Archives of Clinical Neuropsychology 5: 273–285.

    PubMed  Google Scholar 

  • Russell, E. W. (1976). The Bender-Gestalt and the Halstead-Reitan Battery: A case study.Journal of Clinical Psychology 32: 355–361.

    PubMed  Google Scholar 

  • Russell, E. W. (1968). Neuropsychological keys for assessing the localization and process status of cerebral damage. Ph.D. dissertation, University of Kansas.Dissertation Abstracts International, 68, 17, 448 (University Microfilms No. 68-17448).

  • Russell, E. W. (1979). Three patterns of brain damage on the WAIS.Journal of Clinical Psychology 37: 246–253.

    Google Scholar 

  • Russell, E. W. (1980). Tactile sensation: An all-or-none effect of cerebral damage.Journal of Clinical Psychology 36: 858–864.

    PubMed  Google Scholar 

  • Russell, E. W. (1984a). Psychometric parameters of the Average Impairment Rating scale.Journal of Consulting and Clinical Psychology 52, 717–718.

    PubMed  Google Scholar 

  • Russell, E. W. (1984b). Theory and developments of pattern analysis methods related to the Halstead-Reitan battery. In Logue, P. E., and Shear, J. M. (eds.),Clinical Neuropsychology: A Multidiscinlinary Approach, Charles C. Thomas. Springfield, IL, pp. 50–98.

    Google Scholar 

  • Russell, E. W. (1994). The cognitive-metric fixed battery approach to neuropsychological assessment. In Vanderploeg, R. D., (ed.),A Guide to Neuropsychological Practice, Erlbaum, Hillsdale, NJ, pp. 211–258.

    Google Scholar 

  • Russell, E. W., Neuringer, C., and Goldstein, G. (1970).Assessment of brain damage: A Neuropsychological Approach, John Wiley & Sons, New York.

    Google Scholar 

  • Russell, E. W., and Russell, S. L. K. (1993). Left temporal lobe brain damage pattern on the WAIS, Addendum.Journal of Clinical Psychology 49: 241–244.

    PubMed  Google Scholar 

  • Russell, E. W., and Starkey, R. I. (1993).Halstead, Russell Neuropsychological Evaluation System [Manual and Computer program]. Western Psychological Services, Los Angeles.

    Google Scholar 

  • Russell, E. W., Starkey, R. I., Fernandez, C. D., and Starkey, T. W. (1988).Halstead, Rennick. Russell Battery [Manual and Computer program]. Scientific Psychology, Miami, FL.

    Google Scholar 

  • Schreiber, D. J., Goldman, H., Kleinman, K. M., Goldfader, P. R., and Snow, M. Y. (1976). The relationship between independent neuropsychological and neurological detection and localization of cerebral impairment.Journal of Nervous and Mental Disease 162: 360–365.

    PubMed  Google Scholar 

  • Sherer, M., and Adams, R. L. (1993). Cross-Validation of Reitan and Wolfson's Neuropsychological Deficit Scales.Archives of Clinical Neuropsychology 8: 429–435.

    PubMed  Google Scholar 

  • Snow, W. G. (1981). A comparison of frequency of abnormal results in neuropsychological vs. neurodiagnostic procedures.Journal of Clinical Psychology 37: 22–28.

    PubMed  Google Scholar 

  • Spreen, O., and Benton, A. L. (1965). Comparative studies of some psychological tests for cerebral damage.Journal of Nervous and Mental Disease 140: 323–333.

    PubMed  Google Scholar 

  • Stuss, D. T., and Trites, R. L. (1977). Classification of neurological status using multiple discriminant function analysis of neuropsychological test scores.Journal of Consulting and Clinical Psychology 45: 145.

    PubMed  Google Scholar 

  • Swiercinsky, D. P. (1978, September).Computerized SAINT: System for analysis and interpretation of neuropsychological tests. Paper presented at the meeting of the American Psychological Association, Toronto.

  • Swiercinsky, D. P., and Leigh, G. (1979). Comparison of neuropsychological data in the diagnosis of brain impairment with computerized tomography and other neurological procedures.Journal of Clinical Psychology 35: 242–246.

    PubMed  Google Scholar 

  • Swiercinsky, D. P., and Warnock, J. K. (1977). Comparison of the neuropsychological key and discriminant analysis approaches in predicting cerebral damage and localization.Journal of Consulting and Clinical Psychology 45: 808–814.

    PubMed  Google Scholar 

  • Tsushima, W. T., and Wedding, D. (1979). A comparison of the Halstead-Reitan Neuropsychological Battery and computerized tomography in the identification of brain disorder.Journal of Nervous and Mental Disease 167: 704–707.

    PubMed  Google Scholar 

  • Vega, A., and Parsons, O. A. (1967). Cross-validation of the Halstead-Reitan tests for brain damage.Journal of Consulting Psychology 31: 619–625.

    PubMed  Google Scholar 

  • Wedding, D. (1983a). Clinical and statistical prediction.Clinical Neuropsychology 5: 49–55.

    Google Scholar 

  • Wedding, D. (1983b). Comparison of statistical and actuarial models for predicting lateralization of brain damage.Clinical Neuropsychology 4: 15–20.

    Google Scholar 

  • Wedding, D., and Faust, D. (1989). Clinical Judgment and decision making in neuropsychology.Archives of Clinical Neuropsychology, 4: 233–265.

    PubMed  Google Scholar 

  • Wheeler, L., and Reitan, R. M. (1963). Discriminant functions applied to the problem of predicting cerebral damage from behavioral tests: A cross-validation study.Perceptual and Motor Skills 16: 681–701.

    PubMed  Google Scholar 

  • Wheeler, L., Burke, C. J., and Reitan, R. M. (1963). An application of discriminant functions to the problem of predicting brain damage using behavioral tests.Perceptual and Motor Skills 16: 417–440.

    PubMed  Google Scholar 

  • Willis, W. G. (1984). Reanalysis of an actuarial approach to neuropsychological diagnosis in consideration of base rates.Journal of Consulting and Clinical Psychology 52, 567–569.

    PubMed  Google Scholar 

  • Wolfson, D., and Reitan, R. M. (1995). Cross-validation of the General Neuropsychological Deficit Scale (GNDS).Archives of Clinical Neuropsychology 10: 125–131.

    PubMed  Google Scholar 

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Russell, E.W. The accuracy of automated and clinical detection of brain damage and lateralization in neuropsychology. Neuropsychol Rev 5, 1–68 (1995). https://doi.org/10.1007/BF02214929

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