Neuropsychological Diagnostic Accuracy: Factors That Might Lead to a Wrong Diagnosis and How to Avoid Them

Abstract

False positives and false negatives in neuropsychological assessment can occur due to different reasons and they could have serious consequences such as the administration of an unnecessary treatment that may cause adverse effects and failure to provide timely treatment to patients. Therefore, it is important to know how confident we can be in the diagnosis. Tests scores are insufficient to this end. As a starting point, we need to establish hypotheses about the patient’s condition using the information we have collected from several sources. We also need to use information about the psychometric properties of the tests, predictive values and base rates of neurocognitive disorders and low scores. Whenever this information is lacking the interpretation of performance should be cautious. Several strategies are discussed that may contribute to improve diagnostic accuracy.

Keywords

• hypothesis-driven assessment
• sensitivity
• specificity
• false positives
• false negatives
• base rates
• predictive values
• biases
• heuristics