Efficacy of a decision-tree approach to the Luria-Nebraska Neuropsychological Battery.

Abstract

The recent American adaptation of Luria's approach, called the Luria-Nebraska Neuropsychological Battery (LNNB), is designed so that all 269 of its items must be asked of each patient. The present study investigated whether the LNNB items could be arranged in a decision-tree fashion that would allow item administration based on the patient's performance. In the initial experiment, results from 40 standardly administered LNNB, (full-LNNB) were compared with derived results based on the decision-tree administration procedure (decision-LNNB), and it was found that the decision-LNNB was in 91% agreement with full-LNNB scale scores above the brain-impaired cutoff line. Furthermore, using Golden's two-scale elevation rule, the two administration procedures were in 100% agreement in selecting brain-impaired patients. In the second experiment, the decision-LNNB was used alone with 26 brain-impaired patients and 4 normals and was found to have an 87% hit rate, which is comparable to previous reports of the full-LNNB's accuracy. The experiments also revealed that the decision-LNNB allowed the omitting of 76 items, on the average, when used with a sample of brain-impaired and normal subjects.

Comparison of the decision-tree and standard methods of the Luria-Nebraska Neuropsychological Battery.

“…The present study supports the assertions of Webster and Dostrow (1982) that a decision-tree format of the LNNB items can produce essentially the same summary scale results. The finding of comparable results between the standard and decision-tree methods extends beyond the major clinical scales to the localization scales and the factor scales.…”

“…Average number of items omitted by the decision-tree method indicates a substantial savings of time. Webster and Dostrow (1982) have developed a decision-tree version of the Luria-Nebraska Neuropsychological Battery (LNNB) that may facilitate the clinical use of the test. The major premise of the decisiontree version is that initial success on difficult items is used to predict (assume) success on simpler items, which then do not need to be administered.…”

Base rates in neuropsychology.

“…One was the previously noted study by Malloy and Webster (1981). A second study from the same setting (Webster & Dostrow, 1982) also met these criteria, but unfortunately there were obvious errors in the reporting of the number of subjects in the normal and brain-damaged categories, making it impossible to calculate the base rate.…”