1. Wait, There's a Baby in this Bath Water! Update on Quantitative and Qualitative Cut-Offs for Rey 15-Item Recall and Recognition.
- Author
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Poynter K, Boone KB, Ermshar A, Miora D, Cottingham M, Victor TL, Ziegler E, Zeller MA, and Wright M
- Subjects
- Adolescent, Adult, Age Factors, Aged, False Positive Reactions, Female, Humans, Male, Malingering diagnosis, Malingering psychology, Middle Aged, Psychomotor Performance, Reference Values, Reproducibility of Results, Sensitivity and Specificity, Young Adult, Mental Recall, Neuropsychological Tests statistics & numerical data, Recognition, Psychology
- Abstract
Objective: Evaluate the effectiveness of Rey 15-item plus recognition data in a large neuropsychological sample., Method: Rey 15-item plus recognition scores were compared in credible (n = 138) and noncredible (n = 353) neuropsychology referrals., Results: Noncredible patients scored significantly worse than credible patients on all Rey 15-item plus recognition scores. When cut-offs were selected to maintain at least 89.9% specificity, cut-offs could be made more stringent, with the highest sensitivity found for recognition correct (cut-off ≤11; 62.6% sensitivity) and the combination score (recall + recognition - false positives; cut-off ≤22; 60.6% sensitivity), followed by recall correct (cut-off ≤11; 49.3% sensitivity), and recognition false positive errors (≥3; 17.9% sensitivity). A cut-off of ≥4 applied to a summed qualitative error score for the recall trial resulted in 19.4% sensitivity. Approximately 10% of credible subjects failed either recall correct or recognition correct, whereas two-thirds of noncredible patients (67.7%) showed this pattern. Thirteen percent of credible patients failed either recall correct, recognition correct, or the recall qualitative error score, whereas nearly 70% of noncredible patients failed at least one of the three. Some individual qualitative recognition errors had low false positive rates (<2%) indicating that their presence was virtually pathognomonic for noncredible performance. Older age (>50) and IQ < 80 were associated with increased false positive rates in credible patients., Conclusions: Data on a larger sample than that available in the 2002 validation study show that Rey 15-item plus recognition cut-offs can be made more stringent, and thereby detect up to 70% of noncredible test takers, but the test should be used cautiously in older individuals and in individuals with lowered IQ., (© The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2019
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