Description
A groundbreaking and accurate guide to the latest digital technology relevant to neuropsychology clinicians, researchers, and trainees
Neuropsychology in the Age of Digital Health: Exploration, Application, and Practical Implementation, delivers a practical, up-to-date guide to the implementation of digital health tools in clinical and training settings.
This includes authoritative and accurate discussions of the incorporation of digital screening tools and comprehensive assessment methods into neuropsychology practice environments, while also discussing the use of digital cognitive health tools in disease management and how those tools can be used as part of stepped-care models and population health management.
Readers will find:
- Practical advice for integrating new digital tech into clinical and educational settings, with original data gleaned from a survey of current clinical neuropsychology trainees
- Effective strategies for addressing the most pertinent ethical challenges that arise from the use of digital technology in this field
- Examinations of exploratory tools that are useful in research settings and that have potential applications in clinical work
Neuropsychology in the Age of Digital Health is an essential resource for undergraduate and graduate students with an interest in clinical and research neuropsychology, practicing clinical and research neuropsychologists, and students of graduate-level cognitive assessment courses.
Table of Contents
List of Contributors xv
About the Authors xix
Part I Transformation of Neuropsychology in the Digital Age 1
1 The Digital Evolution in Neuropsychology 3
Section 1: Digital Transformation in Neuropsychological Assessment 3
Shifali Singh
Introduction 3
Past and Present: Paper-and-Pencil Tests 4
The Rise of Computerized Neuropsychological Testing 5
A Digital Revolution in Neuropsychology 7
Mobile and Cloud-Based Assessments 7
Passive Digital Biomarkers 8
AI and ml 8
Neurotechnology Integration 8
The Imperative for Continued Technological Evolution 8
Section 2: Neuropsychologists and Digital Tools for Cognitive Health Management 10
Sara Weisenbach
Population Cognitive Health Management 10
Stepped Care for Neuropsychology 10
Challenged to Utilization of Digital Tools in Clinical Settings 11
Part II Current Applications of Technology in Neuropsychology 17
2 Advancing Cognitive Health: Digital Screening Tools 19
Kathryn Marton, Adaeze Njoku, Brianna Clark, and Michelle H. Chen
Introduction 19
Overview of Digital Cognitive Screening Tools 21
Cambridge Neuropsychological Test Automated Battery 21
The Brain Health Assessment 61
Montreal Cognitive Assessment Digital Version 62
Cognivue 63
NIH Toolbox-Cognition Battery 64
Neurotrack 66
BrainCheck 66
Integrated Cognitive Assessment 67
Immediate Post-Concussion and Cognitive Testing 68
The Cogstate Brief Battery 70
NeuroTrax 71
Central Nervous System Vital Signs 72
The Quantified Behavioral Test 74
The MicroCog 76
mci Screen 77
Comparison of Tools by Use Cases 78
Early Detection of mci 78
Concussion Assessments 79
Processing Speed Tests 80
Attention Tests 80
Tests Validated in Pediatric Population 81
Conclusions and Future Directions 81
3 Digital Tools for Assessing Cognitive Health in the Aging Brain 111
Kelly Atkins and Elena Tsoy
Introduction 111
Advantages of Digital Cognitive Assessment 112
Challenges Related to the Use of Digital Cognitive Assessment 114
Overview of Current Digital Cognitive Assessments in Aging Research 115
Special Considerations for the Use of Digital Cognitive Assessments in Low-resource Settings and Diverse Populations 117
Recommendations for Implementation of Digital Cognitive Assessments in Aging Research and Clinical Care 119
Conclusion 120
4 Incorporating and Validating Digital Tools in Clinical Assessment 125
Shifali Singh
Introduction 125
Psychometric Properties and Validation Considerations 126
Reliability 126
Validity 127
Construct Validity 128
Criterion Validity 128
Ecological Validity 128
Benefits of Integrating Digital Neuropsychological Assessment 129
Enhanced Data Collection and Analysis 130
Improved Diagnostic Precision Through Multimodal Assessment 130
Efficiency and Accessibility Through Remote Administration 130
Detailed Process Analysis 131
Integration with Wearable Devices for Continuous Monitoring 131
Scalability and Standardization for Large-scale Applications 132
Data Collection and Interpretation Challenges and Opportunities 132
Environmental and Technology Variability 132
Generalizability Across Devices 133
Access to Novel Tools and Upkeep 133
Sensitivity and Specificity 133
Cultural and Demographic Considerations 133
Standardization and Interoperability 134
Task-based Integration of Clinical Utility 134
Applications in Clinical Practice 134
Future Directions 136
5 Exploratory Digital Tools for Measuring Cognitive Health 141
Section 1: Capturing Behavior in the Real-world with Digital Tools 141
Maureen Schmitter-Edgecombe
Introduction 141
Enhancing Real-world Assessment with Digital Tools 143
Enhancing Real-world Interventions with Digital Tools 145
Clinical Integration of Digital Tools 147
Section 2: Digital Neuropsychology and the Assessment of Cognitive Change 148
Nelson Arley Roque and Laura Thi Germine
Introduction 148
Designing Digital Cognitive Assessments for Broad Accessibility 149
Key Accessibility Barriers and Approaches to Addressing Them 150
Addressing Language Barriers 150
Cultural Barriers to Usability 151
Perceptual–Motor Barriers 151
Digital Literacy 151
Return of Individual Research Results 152
Quantifying Cognitive Changes on Short and Long Timescales 152
Typical Approaches to Measuring Cognitive Change 152
High-frequency Assessment using Digital Technology 153
Dynamic Cognitive Features 153
Selecting Cognitive Tests for Capturing Dynamic Cognitive Features 154
Conclusion 155
Section 3: AI in Clinical Practice 155
Liz Angoff and Gerald Angoff
Introduction 155
Integrating AI into Clinical Practice 156
Limitations and Cautions 159
Conclusions 160
Part III Leveraging Technology for Integration in the Broader Medical System 175
6 Utilizing Digital Tools in Psychiatric Practice 177
Ana F. Trueba-Yepez and Ipsit V. Vahia
Introduction 177
Integration of Technology into Clinical Workflow 178
Lessons Learned from Implementing EMRs 178
Anticipating and Mitigating Roadblocks in Medical Technology Integration 180
Setting-up Office Spaces for the Use of Technological Devices 180
Determining Digital Literacy 181
Digital Literacy and Need for Support in Medical Technology Integration 181
Privacy and Confidentiality 182
Insurance Coverage 182
Digitizing Interventions 183
VR in Psychotherapy 183
Enhancing Mindfulness Through VR 183
Barriers to Pragmatic VR Interventions 183
Accessibility and Cost Considerations 184
Developing a Clinical Workforce Adept at Working with Technologies 184
Digital Phenotypes to Digital Biomarkers 184
New Approaches to Generating and Incorporating Evidence 185
A New Generation of Practice Guidelines 185
New Training Curricula and a New Language of Psychiatry 186
Ethical and Regulatory Concerns and the Potential for New Forms of Liability 187
Conclusion and Summary 187
Sources of Support 188
Disclosures of Potential Conflicts of Interest 188
Other Sources of Funding 188
7 Digital Health Tools in Stepped Care Models 191
Sara Weisenbach
Introduction 191
Stepped Care Models 193
Stepped Care for ADHD Evaluation 194
Stepped Care for Mild and Major Neurocognitive Disorder 195
Integration of Neurotechnology in Neuropsychology Stepped Care Models 196
Conclusion 198
Disclosure Statement 199
Funding Sources 199
8 Population Health Management 203
Section 1: The Role of Neurotechnology in Population Health Management 203
Margaret Lanca
Introduction 203
Factors that Promote Health of a Population 204
Healthcare Spending 204
Social Determinants of Health 205
Healthcare Delivery Imperatives 206
The Critical Need for Technology in Population Healthcare Management 206
Security Considerations 208
Neuropsychology Population Health 208
The Role of Neurotechnology in Neuropsychology 210
Data Structures in Neuropsychology 210
Expanding Neurotechnology Innovations 210
Conclusion 212
Section 2: Leveraging Technology to Tackle Inequalities in Research and Clinical Settings 212
Meredith C. Rowe, Christopher Gonzalez, Averi Giudicessi, Daniel Saldana, and Yakeel T. Quiroz
Current Digital Technologies in Research and Clinical Settings 214
Top of Form 215
Remote and Unsupervised Assessments for Detection of Cognitive Impairment 215
Challenges and Solutions 218
Conclusion and Future Directions 219
Part IV Implementation, Future Directions, and Ethical Challenges 233
9 Training in Technology and Innovation for Clinical Neuropsychology 235
Robert M. Bilder
The “New” Competency in Technology and Innovation: Where Did It Come from? 235
The Minnesota Update Conference 237
Functional Competency in Technology and Innovation: What Is It? 237
Demonstrate Awareness of and the Ability to Incorporate Innovative Methods and Technologies 238
Critically Evaluate Relevant Technologies and Show Awareness and Appreciation for Advantages and Potential Limitations 249
Consider Ethical Issues 250
Training Technology and Innovation Competencies at Different Levels 255
Concluding Remarks 268
10 Neurotechnology in Clinical Practice 273
Stephen Gillaspy and Scott Sperling
Section 1: Financial Considerations When Billing Using Digital Tools 273
Introduction 273
Interprofessional Consultation Services 274
Online Digital Assessment and Management Services 276
Remote Therapeutic Monitoring Services 277
Digital Mental Health Treatment Services 279
11 Neurotechnology and Trainees 285
Ross Divers, Rini Kaplan, Jessica Lanctot, Travis Marchman, Katelin Curtis, Shifali Singh and Sara Weisenbach
Introduction 285
Trainees’ Perspectives on the State of Education on Neurotechnology 287
A Guide for Addressing Training Gaps 289
Envisioning the Future of Neurotechnology in Neuropsychology 290
Appendix A: Survey Questions 293
Appendix B: Survey Results 294
12 Ethical Challenges for Artificial Intelligence in Clinical Practice and Research: A Case Study on People with Dementia 297
Bettina S. Husebo, Justin Haugland-Pruitt, and Monica Patrascu
Introduction 297
AI-driven Tools: a Double-edged Sword 299
Bias in Design 299
Bias in Assumptions 299
Bias in Data 300
Bias in Use 300
Trustworthy AI 301
Legal Framework for Responsible Research and Innovation 302
AI and People with Dementia 304
Consent 304
Data Privacy 304
Algorithmic Bias 305
Case Study 305
Phase I. Pre-funding Assessment 306
Phase II. Post-funding Ethical Approval 311
Discussion 312
Recommendations 313
Index 321
