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Response from the Panel: We thank the neuropsychologists who wrote in response to "Assessment: Neuropsychological testing of adults. Considerations for neurologists." The correspondence indicates that this is an important area of dialogue between neurologists and neuropsychologists, and we are pleased that the Assessment stimulated this exchange of ideas as well as provided guidance to neurologists regarding neuropsychological evaluations. It was not our intention to undermine relationships between neurologists and neuropsychologists as suggested in several of the letters; we regard the collaboration of these two specialties as so integral that it can easily withstand critical examination. The dialogue is also timely because consulting relationships are being affected by an increasing emphasis on evidence-based medicine, the importance of outcome assessments as a means of guiding health services delivery, decreasing use of specialty services, and the need for cost containment. In this response, we reiterate the purpose and development of the Assessment and respond to the letters received.
The purpose of the Assessment is to aid neurologists who consult neuropsychologists in the course of caring for patients with known or suspected brain disorders. The Assessment described both the role and the limitations of neuropsychological testing in neurologic practice based on the available evidence. We did not address the many valuable contributions that neuropsychology has made to understanding the effects of brain disease on behavior. These contributions are impressive but are of limited importance in determining whether a neuropsychological consultation is needed and in aiding a neurologist in caring for the patient.
The neuropsychological assessment was initiated by the Therapeutics and Technology Assessment (TTA) Subcommittee of the American Academy of Neurology(AAN) because neuropsychological assessment is a common consultation made by neurologists and one for which re-examination might improve its utility for neurologists. The panel facilitator (Dr. Cummings) identified an expert panel to develop the …
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