Analysis and interpretation of neuropsychologic tests in cardiac surgery

Neuropsychologic assessment in the context of cardiac surgery is constrained by the clinical time available to see patients, and as such test selection needs to be carefully planned. Besides the time limitations, it differs from clinical neuropsychologic assessment primarily because it tends to involve at least two assessments, a comparison with performance before operation, and a limited number of tests. The analysis and design issues involved in both incidence studies and intervention studies are discussed in this article. Incidence studies customarily involve a single group assessed on at least two occasions and are designed to identify the numbers of individuals who show clear evidence of neuropsychologic changes after a cardiac operation. Intervention studies involve at least two groups where one factor (eg, surgical equipment) is varied systematically. The research on neuropsychologic deficits after cardiac operations has progressed from incidence studies, which involve a conventional definition of deficit, to intervention studies, in which specific test performance can be compared.