Test Poor Effort By Patients In 5 Minutes

NSC Partners has announced it has released its 21-Item Neuropsychological Test iPhone App for licensed clinicians and doctors. The iPhone App was created to test for exaggeration of existing problems or poor effort during the course of a patient's neuropsychological examination by a doctor. The test takes approximately 5 minutes to administer. The App includes the 21-Item Test Research Manual and an initial set of 10 tests. Additional tests may be purchased for as little as $1 each for a set of 50. Patient results are available immediately after completion of the test.

"In the context of a neuropsychological examination, bias refers to a systematic source of variability in test performance that is relatively independent from the individual's true level of ability. Bias can influence both the reliability (e.g., consistency and stability) and validity of neuropsychological test performance. One form of bias is exaggeration of existing problems or poor effort during the course of neuropsychological testing. The 21-Item Test is designed to detect the latter form of bias," said Dr. Michael Franzen co-author of the 21-Item Test.

The 21-Item Test is not a test for malingering; it is a test for biased responding. Biased responding is sometimes referred to as non-optimal, poor, or incomplete effort. Poor and incomplete effort, technically, are not accurate in that the person may be trying very hard to appear impaired. Non-optimal effort is a more accurate term, implying that optimal effort is more likely to result in an obtained score that is closer to the person's true level of ability. However, if the person's objective is to produce scores that do not reflect his or her true level of ability, then the person may not be providing "optimal" effort toward this goal. Therefore, biased responding is probably the most accurate term for describing this test behavior.


The 21-Item Test was an adaptation of the Symptom Validity paradigm popularized by Pankratz and colleagues (Binder & Pankratz, 1987; Pankratz, 1983; Pankratz, Binder, & Wilcox, 1987; Pankratz, Fausti, & Peed, 1975), Hiscock and Hiscock (1989), and Binder (Binder, 1990; Binder & Willis, 1991). Brandt and colleagues adapted the Symptom Validity paradigm to a word list task (Brandt, Rubinsky, & Lassen, 1985; Wiggins & Brandt, 1988); the 21 Item Test was adapted from their work. This word list task takes approximately five minutes to administer and score. Interpretation of performance can be based on binomial probabilities, inconsistencies in performance, or rare levels of performance.

Since the 21-Item Test is most often used to assist the clinician with a determination of malingering, an overview of malingering is provided in Chapter 2. A description of the test, administration instructions, and scoring procedures are provided in Chapters 3 and 4. A summary of research findings and tables of comparison data are found in Chapters 5 and 6. The clinical interpretation of 21 Item Test data is described in Chapter 7. (21 Item Test Research Manual (C)1989 Grant Iverson and Michael Franzen)

A separate End User Licensing Agreement is presented to the purchaser prior to App purchase. This EULA outlines the responsibilities of the clinician or doctor to safeguard patient information in accordance with HIPAA requirements and makes it clear that this App is intended for medical professionals. This App is not a medical device. Healthcare providers should not rely solely upon this application to make medical decisions and instead should rely upon their own independent judgment in accordance with relevant professional guidelines, standards, and applicable laws.

Pricing and Availability:
21-Item Neuropsychological Test 1.0 is $24.99 (USD) and available worldwide exclusively through the App Store in both the Medical and Educational categories. The 21-Item Neuropsychological Test is also available from Apple under their App Store Volume Purchase Program for educational institutions.


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