Identifying key potential outcomes of neuropsychological assessment: An Australian expert consensus study

Within resource-limited health care, it is important to demonstrate the value and impact of neuropsychological assessment (NPA) services. However, the most suitable methods for capturing these outcomes are yet to be established. We aimed to identify key potential outcomes of NPA, existing measures of these outcomes, and issues and challenges associated with outcome measurement.

Focus groups of experienced Australian neuropsychologists discussed possible NPA outcomes, existing measures, and challenges of outcome measurement, analyzed using thematic analysis. The Delphi method of expert consensus was then used to identify the most important set of NPA outcomes, using iterative survey rounds with expert panelists. Panelists also rated the top three outcomes most likely to demonstrate the impact of NPA in trials.

There were 50 potential NPA outcomes generated by the focus groups, spanning proximal and distal patient, caregiver, health service, and societal domains. Numerous issues and challenges were identified associated with meaningfully measuring NPA outcomes. After three Delphi survey rounds (n = 46), a total of 16 outcomes achieved consensus agreement. Few existing validated measures were identified. The top three rated outcomes were 1) better patient and/or caregiver understanding of presenting problems, 2) better patient and/or caregiver understanding of how to manage and cope with cognitive symptoms, and 3) diagnostic clarification.

Psychoeducational benefits of NPA were considered by Australian experts as key outcomes relevant across contexts; however, there are no existing measures of these outcomes. Future research should develop valid outcome measures to be used in clinical trials evaluating NPA impacts.