Publication Abstract Display
Type: Published Manuscript
Title: Predictive validity of global deficit scores in detecting neuropsychological impairment in HIV infection.
Authors: Carey CL, Woods SP, Gonzalez R, Conover E, Marcotte TD, Grant I, Heaton RK, and the HNRC Group
Contact: Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, CA 92103, USA.
Year: 2004
Publication: Journal of Clinical and Experimental Neuropsychology : official journal of the International Neuropsychological Society
Volume: 26 Issue: 3 Pages: 307-19
Abstract:The current study explored the predictive validity of the Global Deficit Score (GDS) approach in summarizing neuropsychological (NP) test results, and specifically in detecting HIV-associated cognitive impairment. A comprehensive NP test battery was administered to 88 HIV+ subjects and 61 healthy HIV- controls comparable for age, education, and ethnicity. Demographically corrected test data were converted to a GDS, which simulates clinicians' ratings by quantifying the number and degree of impaired performances throughout the test battery while attaching relatively less significance to superior performances and/or those within normal limits. Our results indicated that the GDS approach effectively discriminated HIV+ and normal control groups, and accurately classified HIV+ individuals with NP impairment based on the "gold standard" clinical rating approach. Consistent with previous studies using different subject samples and different NP test batteries, the GDS cutpoint of >or=0.50 yielded optimal balance between sensitivity and specificity in classifying NP impairment, thus supporting the generalizability of the method. Moreover, the ability of the GDS to predict NP impairment across several cutpoints was quite strong, with positive predictive power values ranging from 0.71 to 1.00. These findings support the validity of the GDS as a clinically useful way of summarizing results on NP testing.
Funding: NIDA:DA P01DA12065, NIMH:MH P30MH62512-02
Keywords: Adult, Cognition Disorders, Comparative Study, Demography, Female, HIV Infections, Humans, Male, Middle Aged, Motor Activity, Neuropsychological Tests, Predictive Value of Tests, Psychometrics, ROC Curve, Reproducibility of Results, Research Support, U.S. Gov''t, P.H.S.

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