The Making Change Test: Initial validation of a novel digitized performance validity test for tele-neuropsychology.

Abstract

The Making Change Test (MCT) is a brief, digitized freestanding performance validity test (PVT) designed for tele-neuropsychology (TeleNP). The objective of this study was to report the initial validation of the MCT in a mixed neuropsychiatric sample referred for neuropsychological evaluation using a known-groups design. The sample consisted of 136 adult outpatients who underwent a neuropsychological evaluation. Patients were classified as valid (n=115) or invalid (n=21) based on several established PVTs. Two validity indicators were calculated and assessed, including an Accuracy Response-Score and an Abbreviated Index. The Accuracy Response-Score incorporated both response time and errors. The Abbreviated Index aggregated response time and errors across the most sensitive test items in terms of predicting performance validity status. Correlational analyses indicated that the MCT Accuracy Response-Score and Abbreviated Index were more similar to non-memory-based PVTs than memory-based PVTs. Both the MCT Accuracy Response-Score and Abbreviated Index indicated acceptable classification accuracy (area under the curve of .77). The optimal cut score for the MCT Accuracy Response-Score (≥24) yielded a sensitivity of .38 and specificity of .90. The optimal cut score associated with the Abbreviated Index yielded slightly better operating characteristics, with a sensitivity of .50 and specificity of .90. Initial findings provide support for the criterion and construct validity of the MCT and suggest a promising TeleNP future for this performance validity tool. However, additional support is necessary before the MCT can be used clinically.