Revisiting reliable change with Iverson (2001)

Kevin M. Duff

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Psychological Testing and Assessment Dementia and Cognitive Impairment Research Psychometric Methodologies and Testing

Abstract

Objective: Iverson (2001 Iverson, G. L. (2001). Interpreting change on the WAIS-III/WMS-III in clinical samples. Archives of Clinical Neuropsychology, 16(2), 183–191. https://doi.org/10.1016/S0887-6177(00)00060-3[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) expanded on reliable change methodology by accounting for the variability in scores at Time 2 in the calculation of change scores. However, due to limitations in available data, an incomplete picture of variables affecting change was presented. The current paper sought to address some of these limitations and clarify the methodology for assessing reliable change. Method: Using one-year test-retest data on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in older adults who were cognitively intact or had mild Alzheimer’s disease (AD), change scores were calculated, and various models, consistent with or divergent from Iverson, were presented. Results: Across the RBANS, individuals with intact cognition tended to show less variable scores, especially at Time 2, which resulted in larger change scores than those with AD. When applied to an independent sample, different patterns of change were observed, with: (1) models that used intact data showed more cognitive change than those using AD data; (2) the model that corrected for practice effects and used intact data showed the most decline; and (3) the model that corrected for practice effects and used AD data showed the most improvement. The models that showed the strongest association in classifying independent cases as decline/stable/improve were those that used intact data and were discordant on the use of practice effects. Conclusions: Overall, findings highlight the complexity of calculating reliable change, and they lend additional caution to Iverson’s original limitations. However, the use of data from individuals classified as cognitively intact and a correction for practice effects seems warranted.

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References

1991Clinical significance: A statistical approach to defining meaningful change in psychotherapy research.2018Trajectories of normal cognitive aging.2012Scoring Higher the Second Time Around: Meta-Analyses of Practice Effects in Neuropsychological Assessment 1998Repeatable Battery for the Assessment of Neuropsychological Status 2001Interpreting change on the WAIS-III/WMS-III in clinical samples 1998Regression Equations in Clinical Neuropsychology: An Evaluation of Statistical Methods for Comparing Predicted and Obtained Scores 2004The standard error in the Jacobson and Truax Reliable Change Index: The classical approach to the assessment of reliable change 2008Reliable change and practice effects: Outcomes of various indices compared

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