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This week's blog was contributed by Maegan Sady, PhD, ABPP-CN. In addition to being a licensed psychologist and board-certified neuropsychologist, Maegan is a project director in PAR's research and development department. She worked as a pediatric neuropsychologist for nearly a decade before joining PAR.
Psychological assessment allows for three types of clinical decisions: diagnosis, treatment planning, and measuring change over time. Assessment involves integrating information from multiple sources—tests, rating scales, observations, and interviews—to answer a given referral question and provide recommendations.
To best serve clients and patients, providers should engage in evidence-based assessment (EBA; related terms include evidence-based medicine, evidence-based practice, empirically based assessment, and evidence-based instruments). EBA relies on scientific knowledge to help providers make clinical decisions. Although EBA has been a longstanding goal in psychology, clear documentation of EBA standards has been in place for only the past 15–20 years.
Choosing reliable, valid assessment tools is the foundation of EBA. Basic psychometric strengths include representative normative samples, strong internal consistency, sound construct validity, and test–retest statistics (built-in change metrics are a bonus!). Because validity applies to the use of a test for a specific presenting problem in a particular individual, studies using discriminant function analyses and base rates identify the clinical utility of tests for given populations.
To use an EBA approach, ask: What tools can I use to rule the proposed diagnosis in or out? For which related conditions do I need to screen? What else do I need to know about this client to recommend an appropriate treatment? Which tests are sensitive to change in the constructs being targeted?
Increasingly more tools are available to providers to address real and perceived barriers to practicing EBA. Special issues of journals are devoted to using EBA for various conditions, books contain systematic reviews of instruments, and professional organizations have position papers on topics including serial neuropsychological assessment and effort/malingering.
To keep up with advances in research relevant to your practice, create Google Scholar or PubMed alerts to generate periodic emails (use search terms like "evidence-based assessment," "meta-analysis," or "systematic review," along with key disorders) and organize the literature in a free citation manager. For an informal approach, follow known researchers and EBA gurus and join social media groups for your clinical interests. Subscribe to professionally focused podcasts and queue up relevant episodes for your next commute, walk, or hammock session.
At PAR, we aim to propel the growth of EBA by working with our customers to make it easier to search for information about tests and to collaborate on clinical data repositories. Visit the PAR data collection page for more information.
Browse the PAR Learning Center for training and supplemental materials, put our products to the test in your clinical research, and reach out to us if you have data on clinical samples. Though the initial adoption of EBA practices takes time and effort, you'll see the results via more precise decision making and buy-in from clients. It's never too late to jump on the bandwagon!