How Valuable are Clinical Neuropsychological Assessments? A Meta-analysis of Neuropsychological Tests with Comparison to Common Medical Tests and Treatments
Date of Award
Clinical and Counseling Psychology
Benjamin D. Hill, Ph.D.
There has been a general decrease in neuropsychological assessments at a time when medical diagnostic technology and treatments have expanded, leading to a faulty assumption that medical tests and healthcare treatments provide more reliable or valid data than psychological assessments. A landmark report from the American Psychological Association’s (APA) Psychological Assessment Work Group (PAWG) found that validity coefficients for many psychological tests were indistinguishable from those of medical tests (Meyer et al., 2001). An updated systematic review of the advancement in neuropsychological testing is essential to the continued advancement of the value of neuropsychological assessment in healthcare. This meta-analysis sought to (1) summarize effect sizes of neuroimaging to diagnose dementia, medications to treat chronic diseases, and neuropsychological tests to diagnose dementia and TBI, (2) determine the differences (if any) in effect sizes between medical domains, and (3) determine the differences (if any) in effect sizes between medical domains and neuropsychological tests. EBSCO networks were searched for original research examining the efficacy of neuroimaging for Alzheimer’s Disease (AD),neuropsychological tests for AD and traumatic brain injury (TBI), and medication to treat memory impairment and cardiovascular events between clinical and control samples. Studies were coded using a complex multi-comparison, outcome, and subgroup schema. Data were analyzed under random-effects modeling. Of 6,668 studies identified, 78 were retained for primary and ancillary meta-analyses (715 effect sizes extracted; 35,810 clinical and 42,964 control participants represented). Primary results indicated a significant difference between domains, such that neuroimaging (g = -1.603) and neuropsychological tests (g = -1.591) both yielded greater effect sizes than medication studies (g = -0.009]. Secondary results indicated the AD neuropsychological test effect size [g = -2.213) was significantly different than the TBI neuropsychological test efficacy [g = -0.649; Q(1) = 42.821, p = 0.000]. Additionally, results indicated nonsignificant effect sizes for both memory impairment medications (g = -.052) and aspirin for cardiovascular events (g = .017). CONCLUSIONS: The diagnostic efficacy of neuroimaging and neuropsychological tests were both substantial and non-significantly different from one another. These findings provide clinicians and consumers with convincing evidence that neuropsychological tests are a reliable diagnostic tool for people with acquired and neurodegenerative brain disorders.
Harrell, Murphy, "How Valuable are Clinical Neuropsychological Assessments? A Meta-analysis of Neuropsychological Tests with Comparison to Common Medical Tests and Treatments" (2022). Theses and Dissertations. 72.