Comparison of the Repeatable Battery for the Assessment of Neuropsychological Status Effort Scale and Effort Index in a Dementia Sample

Abstract

The aim of the current study was to compare two embedded measures of effort for the repeatable battery for the assessment of neuropsychological status (RBANS). Sensitivity and specificity of the Effort Index (EI) and Effort Scale (ES) were compared in a sample of individuals with genuine memory impairment (MI) and individuals coached to simulate MI. Overall, the EI yielded a sensitivity of 0.89 and specificity of 0.41, while the ES yielded a sensitivity of 0.88 and specificity of 0.81. When those in the MI group were separated by level of impairment, the EI was more specific when RBANS Total Scores were in the average or mildly impaired range, and the ES had greater specificity when RBANS Total Scores were in the severely impaired range. These results suggest that the embedded measure should be selected based on the level of impairment on the RBANS.

Effort Testing in Dementia Assessment: A Systematic Review

“…This profile of impairment is more likely to be seen in AD, which is characterised by a deficit in episodic memory, than in non-AD dementias. Paulson et al (2015) and Dunham et al (2014) investigated the ES in both good and suspect effort groups. They found sensitivity of 0.71 and 0.88 and specificity levels of 0.42 and 0.81 respectively.…”

Dawn simulation light impacts on different cognitive domains under sleep restriction

“…Likewise, after every test session participant had to indicate the effort, concentration and motivation they needed to perform the tests. A 100 mm effort visual analogue scale was used, ranging from "0:little" to "100:much" [21,22].…”

Limitations of performance validity tests in dementia evaluations: The role of base rates.

“…Table 1 shows mean age, sample size, cutoff score, sensitivity, specificity for the respective experimental groups, and PVTs when a 5% base rate of invalid performance is assumed. Aside from a study examining RBANS embedded PVTs, which included a simulator group with a mean age of 27.8 (Dunham et al, 2014), the mean age for all groups included in the studies was greater than 64 years. Across measures, sensitivities ranged from 60% to 100% and specificities ranged from 28% to 100%.…”

“…Studies that reported only specificities, and not also sensitivities, were excluded since sensitivity data were required for Bayesian analyses. Measures for which specificity and sensitivity data were reported include: Test of Memory Malingering (TOMM; Bortnik et al, 2013), Rey 15-item test (Bortnik et al, 2013), MSVT (Singhal et al, 2009), Nonverbal MSVT (NV-MSVT; Singhal et al, 2009), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Effort Index (EI; Bortnik et al, 2013; Dunham et al, 2014; Paulson et al, 2015), and RBANS Effort Scale (ES; Dunham et al, 2014; Paulson et al, 2015). Peer-reviewed publications included in the McGuire et al (2019) review were examined to confirm sample sizes, cut scores, and classification accuracy statistics.…”