Elsevier

NeuroToxicology

Volume 28, Issue 2, March 2007, Pages 235-239
NeuroToxicology

Evaluation of reliability of traditional and computerized neurobehavioral tests

https://doi.org/10.1016/j.neuro.2006.03.004Get rights and content

Abstract

Most Korean blue-collar workers are taking government-mandated medical screening periodically. The periodic neurobehavioral test provides a great chance to evaluate the functional change of the central nervous system. To utilize periodic neurobehavioral tests effectively, the reliability of currently used neurobehavioral tests needs to be evaluated. Test–retest of neurobehavioral tests were conducted to evaluate the reliability of neurobehavioral tests that are commonly used for Korean workers. The test–retest of five computerized tests, simple reaction time, additions, symbol digit, digit span, and finger tapping speed, and five traditional tests, Benton visual retention, digit symbol, digit span, pursuit aiming, and pegboard, were administered to 85 college students and 35 hospital workers over a 1 month interval. Computerized additions was found to have the highest test–retest reliability coefficient (r = 0.90), followed by finger tapping speed (nondominant hand, r = 0.89; dominant hand, r = 0.85), symbol digit (r = 0.82), and digit span (r = 0.74). However, on1y two traditional tests, digit symbol (r = 0.86) and pursuit aiming (r = 0.72), showed a reliability coefficient greater than 0.70. These results suggest that the computerized additions, symbol digit, finger tapping speed, and traditional digit symbol are more satisfactory for periodical evaluation of the central nervous system of workers exposed to neurotoxic substances in Korea.

Introduction

Neurobehavioral tests were introduced in Korea in the early nineties to evaluate the central nervous system disturbance of workers exposed to organic solvents at the workplace. The first neurobehavioral test used in Korea was the World Health Organization neurobehavioral core test battery (WHO-NCTB), followed by computerized neurobehavioral tests. Nowadays both WHO-NCTB, representative traditional neurobehavioral tests and computerized neurobehavioral tests are used together in the field of neurotoxicology of heavy metals and organic solvents (Chung et al., 1998, Chung et al., 2003, Kang, 2000).

Researchers strive to obtain reliable results and examiners usually try to provide an optimal and standardized testing environment. To minimize measurement error, examiners should pay careful attention to the test administration procedure and the process of scoring. Nevertheless, numerous sources of measurement error may arise from the circumstances of administration and scoring process. If it is impossible to eliminate measurement error completely, selection of the neurobehavioral tests which have the highest reliability would be another way to improve the effective application of neurobehavioral tests.

Widely used computerized neurobehavioral tests have been reported to have sufficient stability and reliability by test developers (Campbell et al., 1999, Farahat et al., 2003, Gamberale et al., 1989, Letz et al., 2003, Rohlman et al., 2003). Since all computerized and traditional neurobehavioral tests have been developed and standardized on Western populations, studies on the reliability for Asian populations have been limited. Overall, Asian populations are different from the populations of other continents in terms of racial and cultural background which was also reported as a critical factor that influences neurobehavioral performance (Chung et al., 2003).

In addition, most Korean blue-collar workers have to take government-mandated medical screening every 1 or 2 years according to the kind of hazards. The periodical monitoring system provides a great chance for physicians to evaluate changes of neurobehavioral function. To utilize this advantage effectively, the reliability of currently used neurobehavioral tests needs to be assessed. Herein we report the findings of the test–retest reliabilities of traditional and computerized neurobehavioral tests over a 1 month interval.

Section snippets

Participants

Participants were recruited from a college and university hospital by advertisement. Applicants with a history of serious medical problem which could affect neurobehavioral performance were excluded through physician's interview. Any hospital workers who may have been exposed to neurotoxic substances in the hospital were also excluded. One hundred twenty healthy college students and hospital workers were enrolled and administered test–retest of traditional and computerized neurobehavioral tests

Results

Eighty-five college students and 35 hospital workers participated. Sixty-eight percent of the participants were male and eighty percent of hospital workers had more than 12 years of education (see Table 1).

In the computerized neurobehavioral tests, most of the representative parameters showed an acceptable range of reliability coefficient (r = 0.74–0.90). The highest reliability coefficient was additions (r = 0.90), followed by finger tapping speed of nondominant hand (r = 0.89), of dominant hand (r = 

Discussion

In Korea, most blue-collar workers take a government-mandated medical screening every 1 or 2 years. Early detection of unusually reduced cognitive function or subtle decline of neurobehavioral performance over time needs sufficiently reliable tests. Because the baseline level of neurobehavioral performance has a relatively large variance, therefore, when a neurobehavioral test is administered periodically, reliability is a more important dimension than validity.

There are numerous methods

Acknowledgement

This work was supported by grant no. R01-2005-000-11081-0 from the Basic Research Program of the Korea Science & Engineering Foundation.

References (16)

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