The Development and Psychometric Evaluation of a Supplementary Index Score of the Neuropsychological Assessment Battery Screening Module that is Sensitive to Traumatic Brain Injury

Research output: Contribution to journalArticle


  • David Hacker
  • Christopher A Jones
  • Zoe Clowes
  • Murugan Sitaraman
  • David Davies
  • Ross Taylor
  • Elizabeth Flahive
  • Clare Travis
  • Nicci O'Neil
  • Yvonne Pettigrew

Colleges, School and Institutes

External organisations

  • Clinical Neuropsychology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust
  • Centre for Cardiovascular Sciences; School of Clinical and Experimental Medicine; University of Birmingham; Edgbaston Birmingham UK
  • Department of Occupational Therapy, University Hospitals Birmingham NHS Foundation Trust, UK.


Objective: This study examines the validity of the NAB Screening Module (screening module of the neuropsychological assessment battery, S-NAB) in an acute traumatic brain injury (TBI) inpatient population and provides psychometric evaluation of an original index sensitive to TBI impairment.

Method: The utility of the S-NAB as a TBI screen was examined using a between groups design. One-hundred and four patients with mild complicated to severe TBI were recruited from a consecutive cohort of patients admitted as inpatients to a UK Major Trauma Centre. Ninety-eight control participants were selected from the S-NAB normative sample. All TBI patients completed the S-NAB during their inpatient stay.

Results: Control participants scored significantly higher than TBI participants on the Total Screening index (t = 3.626, p < 0.01), The Attention index (t = 7.882, p < 0.01), and the Executive index (t = 5.577, p < 0.01). A briefer TBI Impairment index of six subtests was constructed which accurately discriminated TBI patients from normative controls (t = 9.9, p < 0.01; Cohen's d = 1.54). The TBI index had excellent classification accuracy (AUC = 0.83), superior to that of the standard S-NAB indices. The TBI Index, Attention Index, and Total Screening Index demonstrated increasing impairment with increased severity of injury.

Conclusions: The S-NAB TBI index is a robust, reliable screening index for use with acute TBI patients, which is sensitive to the effects of acute TBI. It affords a briefer cognitive screen than the S-NAB and demonstrates a dose response relationship to TBI severity.


Original languageEnglish
Pages (from-to)215-227
Number of pages13
JournalArchives of Clinical Neuropsychology
Issue number2
Early online date22 Oct 2016
Publication statusPublished - Mar 2017


  • Adult, Attention Deficit Disorder with Hyperactivity, Brain Injuries, Traumatic, Cognition Disorders, Cohort Studies, Executive Function, Female, Glasgow Outcome Scale, Humans, Logistic Models, Male, Mass Screening, Memory, Middle Aged, Neuropsychological Tests, ROC Curve, Severity of Illness Index, Journal Article