Magazine article Clinical Psychiatry News

Online Neurocognitive Test Is Versatile Clinical Tool

Magazine article Clinical Psychiatry News

Online Neurocognitive Test Is Versatile Clinical Tool

Article excerpt

EXPERT ANALYSIS AT THE INSTITUTE ON PSYCHIATRIC SERVICES

NEW YORK -- An online neurocognitive test designed to provide reliable objective information about memory, concentration, and emotional well-being is a highly effective tool not only for guiding patients to appropriate therapy but for establishing the credibility of the clinician, according to the description of one such tool at the American Psychiatric Association's Institute on Psychiatric Services.

The neurocognitive evaluation, which most patients complete on their home computers, "employs explicitly measured scales that reassure patients that I have considered multiple factors and am not just giving my off-the-hip guess and impression," reported Dr. Joseph J. Parks, director of MOHealthNet, the Medicaid authority for Missouri in Jefferson City.

Several proprietary evaluation systems are available, according to Dr. Parks, but his experience has been with a tool called WebNeuro. Physicians develop an account on this online system and then assign a unique code to patients for access. The assessment, which employs validated and standardized tests of cognitive function and related psychometric fields, such as mood and coping skills, takes about 35 minutes to complete.

Results, which are based on comparisons with normative data in a large database, are generated almost immediately. For typical patients, Dr. Parks estimated that it takes 3-5 minutes to interpret the results. Validation studies include one published in 2007 (Behav Res Methods. 2007 Nov;39[4]:940-9).

This assessment tool has a broad number of options over other alternatives, according to Dr. Parks, who called traditional bedside neurocognitive tests "lame." He suggested that the information gleaned from asking patients to spell words backward or perform uncommon math problems is "unimpressive.' Ultimately, "you don't perform these tests most of the time because you have no respect for their value."

Referring patients for assessment by a neurocognitive psychologist or psychiatrist is another option, but Dr. Parks noted that these specialists are in short supply and not always willing to perform evaluations not linked to treatment. Moreover, it might take weeks for a referral to lead to an appointment and then another delay before the specialist provides a report that is "longer than I need. …

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