Topic 1: Introduction

Question 1

What is a major issue facing clinical neuropsychologists?

Answer 1

getting financially reimbursed for the services they provide

Question 2

For clinical neuropsychology to flourish as a profession, two types of ‘data’ or ‘evidence’ are needed, which?

Answer 2

• ‘evidence-based’ outcome studies that demonstrate the efficacy and the cost-effectiveness of our procedures and interventions,
• another crucial type of ‘data’ needed is for individual practicing clinicians to demonstrate clearly to the referring physicians the value of their clinical judgement in patient care

Question 3

What is the end result we our profession will lose economic footing in an already struggling healthcare economy?

Answer 3

• clients or patients will be seen only on a ‘fee for service’ basis, which only some families can afford
• the other impact will be an expanding trend of neuropsychologists to do more ‘medical-legal’ work to survive economically

Question 4

For our profession to grow, clinical neuropsychologists need to …

Answer 4

they need to remain active in providing both patient care and conducting research relevant to our field.

Question 5

The value of our work is ultimately judged by four individuals …

Answer 5

• the patient
• a relevant family member
• the referral source
• the payor for the services we provide

Question 6

Outcome studies demonstrate …

Answer 6

that neuropsychological tests are reliable and valid instruments for helping answer diagnostic questions

Question 7

What kind of studies are often considered as the gold standard for documenting scientific research?

Answer 7

Randomized Controlled Trails (RCT)

Question 8

Name four basic types of cost analysis studies used in outcome research?

Answer 8

• cost-efficiency / minimization
• cost-benefit
• cost-effectiveness
• cost-utilization

Question 9

What do cost-effectiveness studies measure?

Answer 9

the relative healthcare benefit of at least two different treatments, and relate the degree of benefit relative to the costs involved

Question 10

Which concept is intrinsic to cost-outcome research?

Answer 10

the concept of value

Question 11

Definition of value

Answer 11

value refers to the ‘worth’ of the service, and this can be measured both objectively and subjectively.

Question 12

Neuropsychologists are important in various area’s, which area’s?

Answer 12

• helping with differential diagnosis
• doing presurgical evaluations
• when neurosurgeons request objective information about change and neuropsychological functioning after surgery
• in rehabilitation
• doing medical-legal cases
• making practical decisions regarding patient care

Question 13

two most common neuropsychological consequences of TBI…

Answer 13

decreases in speed of information processing and memory

Question 14

There exists a dose-response relationship between simple speed of performance and TBI severity, this led to the recognition that…

Answer 14

disturbances of white matter tracts following TBI may be the basis of many neuropsychological impairments