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Biomedical subjects

Russell L Adams

Publications and source records attributed to Russell L Adams.

At least 19 recordsLinked to original sources

Test performance and classification statistics for the Rey Auditory Verbal Learning Test in selected clinical samples.

The Rey Auditory Verbal Learning Test [RAVLT; Rey, A. (1941). L'examen psychologique dans les cas d'encéphalopathie traumatique. Archives de Psychologie, 28, 21] is a commonly used neuropsychological measure that assesses verbal learning and memory. Normative data have been compiled [Schmidt, M. (1996). Rey Auditory and Verbal Learning Test: A handbook. Los Angeles, CA: Western Psychological Services]. When assessing an individual suspected of neurological dysfunction, useful comparisons include the extent that the patient deviates from healthy peers and also how closely the subject's performance matches those with known brain injury. This study provides the means and S.D.'s of 392 individuals with documented neurological dysfunction [closed head TBI (n=68), neoplasms (n=57), stroke (n=47), Dementia of the Alzheimer's type (n=158), and presurgical epilepsy left seizure focus (n=28), presurgical epilepsy right seizure focus (n=34)] and 122 patients with no known neurological dysfunction and psychiatric complaints. Patients were stratified into three age groups, 16-35, 36-59, and 60-88. Data were provided for trials I-V, List B, immediate recall, 30-min delayed recall, and recognition. Classification characteristics of the RAVLT using [Schmidt, M. (1996). Rey Auditory and Verbal Learning Test: A handbook. Los Angeles, CA: Western Psychological Services] meta-norms found the RAVLT to best distinguish patients suspected of Alzheimer's disease from the psychiatric comparison group.

Adolescent↗

Prediction errors of the Oklahoma Premorbid Intelligence Estimate-3 (OPIE-3) stratified by 13 age groups.

The Oklahoma Premorbid Intelligence Estimate-3 (OPIE-3) combines Wechsler Adult Intelligence Scale-3rd edition (WAIS-III) subtest raw scores (vocabulary, information, matrix reasoning, and picture completion) and demographic data (i.e., age, education, gender, ethnicity, and region) to predict FSIQ scores. Differences between OPIE-3 estimated FSIQ scores and actual FSIQ scores were compared across 13 age groups in a random sample (N=1201) of the WAIS-III standardization sample. There were mean differences in estimated FSIQ between age groups (P<.01). There was a trend that the OPIE-3 algorithms underestimated FSIQ for individuals 16-17 (2.7 points) and 80-89 years old (3.5 points). However, the differences in estimation errors were small and the percentage of individuals misclassified by more than 10 FSIQ points by age group was similar across groups. The OPIE-3(2ST), OPIE-3MR, and OPIE-3VOC yielded robust estimates of FSIQ across age groups in a neurologically intact sample. Limitations, particularly with individuals aged 16-17 and 85-89 years, are discussed.

Adolescent↗

Clinical validation of the General Ability Index--Estimate (GAI-E): estimating premorbid GAI.

The clinical utility of the General Ability Index--Estimate (GAI-E; Lange, Schoenberg, Chelune, Scott, & Adams, 2005) for estimating premorbid GAI scores was investigated using the WAIS-III standardization clinical trials sample (The Psychological Corporation, 1997). The GAI-E algorithms combine Vocabulary, Information, Matrix Reasoning, and Picture Completion subtest raw scores with demographic variables to predict GAI. Ten GAI-E algorithms were developed combining demographic variables with single subtest scaled scores and with two subtests. Estimated GAI are presented for participants diagnosed with dementia (n = 50), traumatic brain injury (n = 20), Huntington's disease (n = 15), Korsakoff's disease (n = 12), chronic alcohol abuse (n = 32), temporal lobectomy (n = 17), and schizophrenia (n = 44). In addition, a small sample of participants without dementia and diagnosed with depression (n = 32) was used as a clinical comparison group. The GAI-E algorithms provided estimates of GAI that closely approximated scores expected for a healthy adult population. The greatest differences between estimated GAI and obtained GAI were observed for the single subtest GAI-E algorithms using the Vocabulary, Information, and Matrix Reasoning subtests. Based on these data, recommendations for the use of the GAI-E algorithms are presented.

Algorithms↗

Examining the repeatable battery for the assessment of neuropsychological status: factor analytic studies in an elderly sample.

OBJECTIVE: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), a recently developed cognitive assessment instrument, has been shown to be useful with a variety of neuropsychiatric conditions, but its factor structure has not been examined. METHOD: Using 824 community-dwelling elders, the RBANS was examined with confirmatory and exploratory factor analyses. RESULTS: The existing structure of the RBANS was not supported; however, a two-factor solution was. CONCLUSIONS: Clinicians and researchers using the RBANS should be cautious when interpreting this measure with its existing structure.

Aged↗

RBANS index discrepancies: base rates for older adults.

The present study expands upon the data available in the manual of the Repeatable Battery for the Assessment of Neuropsychological Status, by providing base rate data on Index discrepancies that are organized by general level of ability and include both age and education corrections. The data presented are based on the performances of a sample of 718 community dwelling older adults. These findings offer the possibility of increased sensitivity at detecting clinically significant differences that might not be identified when relying on base rate data from a greater age range. Similarly, these data highlight the mediating effects of the global level of cognitive functioning on discrepancy scores.

Aged↗

The relationship between executive functioning and verbal and visual learning and memory.

Executive functions, which include an individual's ability to develop a response set, inhibit behaviors, plan, and reason, likely impact other areas of cognitive functioning, such as learning and memory. The present study examined the relationship between executive functioning and a wide array of standardized, clinical verbal and visual learning and memory measures in 212 patients referred for a neuropsychological evaluation. IQ was also included in the analyses. Results of the canonical correlation analyses indicated that the two cognitive domains shared 55-60% of variance, and two canonical variates were present. Although causality cannot be inferred, a clear and robust relationship between executive functioning and memory is evident, and clinicians should consider this overlap when interpreting poor performance among these two domains.

Adolescent↗

Regression-based formulas for predicting change in RBANS subtests with older adults.

Repeated neuropsychological assessments are common with older adults, and the determination of clinically significant change across time is an important issue. Regression-based prediction formulas have been utilized with other patient and healthy control samples to predict follow-up test performance based on initial performance and demographic variables. Comparisons between predicted and observed follow-up performances can assist clinicians in making the determination of change in the individual patient. The current study developed regression-based prediction equations for the twelve subtests of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in a sample of 223 community dwelling older adults. All algorithms included both initial test performances and demographic variables. These algorithms were then validated on a separate elderly sample (n = 222). Minimal differences were present between Observed and Predicted follow-up scores in the Validation sample, suggesting that the prediction formulas would be useful for practitioners who assess older adults. A case example is presented that utilizes the formulas.

Age Factors↗

Test-retest stability and practice effects of the RBANS in a community dwelling elderly sample.

Repeated neuropsychological assessments are common with older adults, and the determination of true neurocognitive change is important for diagnostic assessment. Several statistical formulas are available to assist in this determination, but they rely on access to test-retest stability coefficients and practice effect values. The current study presents data on these psychometric properties of the RBANS in a large community dwelling elderly sample. Across a one-year retest interval, stability coefficients ranged from .58 to .83 for the Index scores, and from .51 to .83 for the subtest scores. Practice effects were largely absent, with most performances slightly decreasing at retest. These psychometric properties are contrasted with those reported in the RBANS manual, and possible reasons for these differences are discussed. A case example is provided that demonstrates the use of the current findings in conjunction with existing change formulas.

Aged↗

Base rates of longitudinal RBANS discrepancies at one- and two-year intervals in community-dwelling older adults.

Identification of clinically significant change in performance over time on neurocognitive tests is an important aspect of neuropsychological evaluation; however, scant published empirical data exists to guide the clinician in determining the significance of psychometric change across clinically relevant retest intervals. The present study presents base rate data of RBANS score discrepancies in a user-friendly manner based on the performances of a large sample (n=283) of community-dwelling older adults. Data for 1- and 2-year retest intervals are presented in a tabular form that can be used as a convenient reference. Base rates of discrepancy scores were calculated and organized into three groups (i.e., below average, average, and above average) with respect to the participants' OKLAHOMA age- and education-corrected RBANS Total Scale score (Duff, Patton, Schoenberg, Mold, Scott, & Adams, 2003) at initial assessment, in an effort to reduce the influence of regression to the mean and practice effects that is associated with varying levels of cognitive ability. (e.g., Rapport, Axelrod, Theisen, Brines, Kalechstein, & Ricker, 1997; Rapport, Brines, Axelrod, & Theisen, 1997). These data may be helpful in clinical practice by assisting the clinician in determining the clinical significance of score changes.

Age Factors↗

Development of the WAIS-III general ability index estimate (GAI-E).

The WAIS-III General Ability Index (GAI; Tulsky, Saklofske, Wilkins, & Weiss, 2001) is a recently developed, 6-subtest measure of global intellectual functioning. However, clinical use of the GAI is currently limited by the absence of a method to estimate premorbid functioning as measured by this index. The purpose of this study was to develop regression equations to estimate GAI scores from demographic variables and WAIS-III subtest performance. Participants consisted of those subjects in the WAIS-III standardization sample that has complete demographic data (N=2,401) and were randomly divided into two groups. The first group (n=1,200) was used to develop the formulas (i.e., Development group) and the second (n=1,201) group was used to validate the prediction algorithms (i.e., Validation group). Demographic variables included age, education, ethnicity, gender and region of country. Subtest variables included vocabulary, information, picture completion, and matrix reasoning raw scores. Ten regression algorithms were generated designed to estimate GAI. The GAI-Estimate (GAI-E) algorithms accounted for 58% to 82% of the variance. The standard error of estimate ranged from 6.44 to 9.57. The correlations between actual and estimated GAI ranged from r=.76 to r=.90. These algorithms provided accurate estimates of GAI in the WAIS-III standardization sample. Implications for estimating GAI in patients with known or suspected neurological dysfunction is discussed and future research is proposed.

Abstracting and Indexing↗

Predicting change with the RBANS in a community dwelling elderly sample.

Repeated neuropsychological assessments are common with older adults, and the determination of clinically significant change across time is an important issue. Regression-based prediction formulas have been utilized with other patient and healthy control samples to predict follow-up test performance based on initial performance and demographic variables. Comparisons between predicted and observed follow-up performances can assist clinicians in determining the significance of change in the individual patient. In the current study, multiple regression-based prediction equations for the 5 Indexes and Total Score of the RBANS were developed for a sample of 223 community dwelling older adults. These algorithms were then validated on a separate elderly sample (N = 222). Minimal differences were present between observed and predicted follow-up scores in the validation sample, suggesting that the prediction formulas are clinically useful for practitioners who assess older adults. A case example is presented that illustrates how the algorithms can be used clinically.

Aged↗

Differential estimation of verbal intelligence and performance intelligence scores from combined performance and demographic variables: the OPIE-3 verbal and performance algorithms.

Data from the WAIS-III standardization sample (The Psychological Corporation, 1997) was used to generate VIQ and PIQ estimation formulae using demographic variables and current WAIS-III subtest performances. The sample (n = 2450) was randomly divided into two groups; the first was used to develop formulas and the second to validate the regression equations. Age, education, ethnicity, gender, region of the country as well as Vocabulary, Matrix Reasoning, and Picture Completion subtests raw scores were used as predictor variables. Prediction formulas were generated using a single verbal and two performance subtest algorithms. The VIQ OPIE-3 model combined Vocabulary raw scores with demographic variables. The PIQ estimation algorithm used Matrix Reasoning and Picture Completion raw scores with demographic variables. The formulas for estimating premorbid VIQ and PIQ were highly significant and accurate in estimation. Differences in estimated VIQ and PIQ scores were evaluated and the OPIE-3 algorithms were found to accurately predict VIQ and PIQ differences within the WAIS-III standardization sample.

Algorithms↗

The persistent belief that VIQ-PIQ splits suggest lateralized brain damage.

There is a persistent belief in clinical psychology and neuropsychology that the Verbal IQ-Performance IQ (VIQ-PIQ) split can be used to reliably infer lateralized brain damage. We selected samples of patients with cleanly lateralized right (n = 23) or left (n = 26) hemisphere lesions and used Bayesian analyses to study the predictive validity of the Wechsler Adult Intelligence Scale-Revised VIQ-PIQ difference scores for identifying lateralized brain damage. The patients showed average VIQ-PIQ differences in the expected direction. However, on the basis of sensitivity, specificity, and positive predictive value statistics, we concluded that (a) the VIQ-PIQ split has no diagnostic predictive validity in persons with left hemisphere lesions (who are not aphasic) and (b) the VIQ-PIQ split has very limited diagnostic predictive validity in persons with right hemisphere lesions.

Adult↗

An evaluation of the clinical utility of the OPIE-3 as an estimate of premorbid WAIS-III FSIQ.

The clinical utility of the Oklahoma Premorbid Intelligence Estimate--3 (OPIE-3; Schoenberg, Scott, Duff, & Adams, 2002) in estimating premorbid FSIQ was investigated with the WAIS-III standardization sample. The OPIE-3 algorithms combine Vocabulary, Information, Matrix Reasoning, and Picture Completion subtest raw scores with demographic variables to predict FSIQ. Estimated WAIS-III FSIQ scores are presented for patients' diagnosed with dementia, traumatic brain injury, Huntington's disease, Korsakoff's disease, chronic alcohol use, temporal lobectomy, and schizophrenia. A group of patients with depression was employed as a clinical control group. The OPIE-3V and OPIE-3MR algorithms performed well, with the average predicted FSIQ of the combined clinical sample approximating the mean FSIQ of healthy adults. The OPIE-3(Best), which is a procedure that employs either the OPIE-3V, OPIE-3MR, or OPIE-3(2ST) algorithms in a best performance method, is presented. Recommendations in the application of the OPIE-3 are made and future research is proposed.

Brain Diseases↗

Age- and education-corrected independent normative data for the RBANS in a community dwelling elderly sample.

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, Randolph, 1998) is likely to become a popular screening instrument for measuring cognitive functioning, particularly in elderly patients. As such, the present study attempted to extend the original normative data by reporting on RBANS performances in a group of 718 community dwelling older adults. Participants were recruited from an outpatient primary care setting, and were assessed for demographic, medical status, functional status, and quality of life information. Utilizing four empirically supported overlapping midpoint age ranges, individual subtest raw scores were converted to age-corrected scaled scores based on their position within a cumulative frequency distribution. These age-corrected scaled scores were also converted into education-corrected scaled scores using the same methodology across four education levels. Independent Index and Total scores were also calculated based on the data from this large elderly sample. These data may considerably advance the clinical utility of the RBANS by allowing clinicians to interpret individual subtests and make direct comparisons between subtests. Practitioners and researchers who elect to use the current normative data are encouraged to consider the similarities and differences between the present sample and their individual patients or research participants.

Aged↗

Performance of cognitively normal African Americans on the RBANS in community dwelling older adults.

Recent research suggests that cognitively normal African Americans are more likely to be misdiagnosed as impaired compared to Caucasians due to lower neuropsychological test scores (e.g., Manly et al., 1998). Given this, the present study sought to determine whether such racial discrepancies exist on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Performances of 50 cognitively normal older African Americans on the RBANS were compared to those of 50 Caucasians matched on age, education, and gender. The African Americans scored significantly lower on 10 of 12 subtests, 3 of 5 Index scores, and the Total Scale score. Results underscored the utility of demographically appropriate norms when serving minority clients. Given that there remains a paucity of normative data for minority groups, RBANS normative data for older African Americans are provided. Although preliminary, it is hoped that data presented will offer the practitioner assistance with clinical diagnosis and decision-making in a manner that will help minimize diagnostic errors.

Black or African American↗

Using the Halstead-Reitan Battery to diagnose brain damage: a comparison of the predictive power of traditional techniques to Rohling's Interpretive Method.

The aim of this project was to validate an alternative global measure of neurocognitive impairment (Rohling Interpretive Method, or RIM) that could be generated from data gathered from a flexible battery approach. A critical step in this process is to establish the utility of the technique against current standards in the field. In this paper, we compared results from the Rohling Interpretive Method to those obtained from the General Neuropsychological Deficit Scale (GNDS; Reitan & Wolfson, 1988) and the Halstead-Russell Average Impairment Rating (AIR; Russell, Neuringer & Goldstein, 1970) on a large previously published sample of patients assessed with the Halstead-Reitan Battery (HRB). Findings support the use of the Rohling Interpretive Method in producing summary statistics similar in diagnostic sensitivity and specificity to the traditional HRB indices.

Adult↗