1. LOINC for Patient-Reported and Clinician-Administered Psychological Tests Saul Rosenberg, PhD Clinical LOINC Meeting January 28, 2011 Tucson, AZ

2. Patient-Reported = Self-Report Tests Psychological Self-Report Tests: Questionnaires, inventories, scales, measures, or metrics that have been standardized on one or more populations, groups or subgroups Published reliability data (test-retest, inter-judge) Published validity data (construct, discriminant, incremental) With a manual for administration, scoring and interpretation

3. Widely Used Tests MMPI-2 Personality Assessment Inventory Beck Depression Inventory Wechsler Adult Intelligence Scale Delis-Kaplan Executive Function Test Rorschach Inkblot Test Inventory of Interpersonal Problems

4. Psychological Testing and Psychological Assessment Psychological testing: The administration, scoring and data entry for a single psychological test. Psychological assessment : the integration of multiple tests and structured interviews for diagnosis of mental disorders, treatment planning, disability determination, comparative effectiveness research.

5. PROMIS PROMIS is a collection of self-report tests to provide measures of patient-reported outcomes (status at a point in time). PROMIS is an ideal tool for screening PROMIS items can be read to a patient, administered on paper, or used for computer based adaptive testing. PROMIS offers a set of rigorously designed questions about different aspects of health-related quality of life (pain, fatigue, anxiety, depression, social functioning, physical functioning, quality of sleep, etc.).

6. Surveys Surveys are designed to study a population, group or sub-group, e.g. a survey of teen-age use of alcohol Surveys are not used for diagnosis, treatment planning and treatment monitoring for an individual patient. Surveys assume unbiased responding – psychological tests measure exaggeration or minimization.

7. Examples of PROMIS items: In the past 7 days…. I reacted slowly to things that were said or done I felt lonely even when I was with other people I felt that I had no energy I felt worthless I felt that I had nothing to look forward to Each item is rated: 1 = Never 2 = Rarely 3 = Sometimes 4 = Often

8. Clinician Administered Tests Neurocognitive test for short-term memory Primarily administered by psychologists Instructions: “I am going to say some numbers and I want you to repeat them back to me” 3 8 2 9 Now I am going to say some more numbers and I want you to repeat them in backwards order: 5 7 4 9

9. Which Tests Qualify for LOINC? Who Decides? There are thousands of psychological tests. How will the LOINC committee decide which tests to prioritize? Popular tests? Best selling tests? Free tests? None of the above All tests nominated for LOINC should be curated by the relevant professional associations Test authors or publishers should submit their tests to a relevant professional organization.

10. Professional Associations American Psychological Association American Psychiatric Association National Academy of Neuropsychology Society for Behavioral Medicine Health Psychology (a group within APA) American Neurological Association Etc. ***

11. Saul Rosenberg, PhD Clinical, Neuropsychological & Forensic Psychology Clinical Professor & Research Psychologist Dept. of Psychiatry, School of Medicine University of California, San Francisco CEO, Neuron Valley Networks EMAIL: saul@rosenbergphd.com OFF: (415) 925-3086 CELL: (415) 924-1151