Understanding tests

Just because a test is published does not mean that it is a good test, any more than all published papers are good papers. The onus is upon the test user to be sufficiently knowledgeable about test theory to gauge the strengths and limitations of tests. Common problems with tests are small standardization sample sizes, unknown or unstable factor structure, poor or no theoretical adequacy, poor or no use of criterion groups, vague scoring criteria, and poor or no information on difference scores within or between tests. It is worth reading the manual of the Children's Memory Scale (1Z> as a good example of a psychometrically well-constructed test.

Another point to bear in mind is that even a well-normed and proven test may not actually be applicable to the particular patient at hand; tests only have a certain range of convenience. Tests have to be very carefully chosen when confounding factors are present, such as when English is not the patient's first language or when there is a sensory or motor deficit (e.g. visual problems affecting acuity or scanning, dysarthria affecting speed of verbal response, upper-limb paresis affecting manipulation of test materials).

Indeed, there are a range of potentially confounding variables even in those patients who are within the range of convenience of the test. These include effects of medication, fatigue as the testing progresses, motivation, mental state, disturbed behaviour, cultural background and beliefs, and educational background. Test manuals may provide information on such potentially confounding variables, but often it is necessary to know the primary research on the test and its sensitivity to such factors.

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