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Lessons learned--15 years of the WHO-NCTB: a review
Neurotoxicology
|December 29, 2000
Summary
The Neurobehavioral Core Test Battery (NCTB) effectively detects neurotoxicity in educated adults but faces challenges with lower education levels and diverse cultural groups. Refinements are needed to ensure accurate neurotoxicity assessment globally.
Area of Science:
- Neuroscience
- Toxicology
- Psychometrics
Background:
- The World Health Organization (WHO) recommended the Neurobehavioral Core Test Battery (NCTB) in 1983 for global neurotoxicity detection.
- The NCTB comprises seven standardized neurobehavioral tests.
Purpose of the Study:
- To review lessons learned from using the NCTB in working populations across diverse global settings.
- To assess the effectiveness and limitations of the NCTB in various cultural and educational contexts.
Main Methods:
- A mini-symposium in 1999 brought together speakers reviewing 94 studies utilizing the NCTB.
- Data from studies conducted in Africa, Asia, Europe, and North America were discussed.
- Key challenges and successes of NCTB implementation were identified.
Main Results:
- The NCTB is reliable for adults with 12+ years of education but not for those with less than 9 years.
- Cultural differences impact NCTB effectiveness, particularly for aboriginal and African populations, necessitating construct validation in diverse countries.
- Profile of Mood States (POMS) and Digit Symbol tests showed sensitivity to neurotoxic exposures, though POMS was culturally influenced.
- Examiner drift and scoring reliability issues (e.g., Pursuit Aiming II) were noted.
Conclusions:
- The NCTB is a valuable tool for neurotoxicity assessment in specific populations but requires adaptation and validation for broader global and diverse cultural use.
- Further research is recommended to establish construct validity across a wider range of countries and to address implementation challenges like examiner training and scoring consistency.
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