Alternate Scoring of the Paced Auditory Serial Addition Test (PASAT): Evaluating Strings of Consecutive Correct Responses as Predictors of Cognitive Functioning in Patients with Multiple Sclerosis

• Published in: Archives of clinical neuropsychology Vol. 29; no. 6; pp. 555 - 556
• Main Authors: D'Orio, V, Foley, F, Zemon, V, Holtzer, R
• Format: Journal Article
• Language: English
• Published: 01.09.2014
• ISSN: 0887-6177; 1873-5843
• DOI: 10.1093/arclin/acu038.138

Objective: The Paced Auditory Serial Addition Test (PASAT) is a commonly used test for patients with multiple sclerosis (MS). This study evaluated the usefulness of novel scoring methods of the test, including the total number of three, four, and five consecutive correct responses as well as the longest string of consecutive correct responses for predicting overall cognitive function and detecting impairment. Strings were compared to traditional total correct and the more recently developed dyad scores. Method: 201 MS patients seen for neuropsychological evaluation at an outpatient MS clinic in New Jersey were administered the Minimal Assessment of Cognitive Function in MS (MACFIMS) battery. Overall cognitive functioning was represented by a composite z-score of all test performances excluding the PASAT. Cognitive impairment was defined in three ways for the analyses: composite z-score < -1 and < -1.5, and at least two cognitive domains with composite z-scores < -1.5. Results: Each scoring variable was found to be effective at predicting overall cognitive functioning and classifying those with cognitive impairment in separate regression analyses (p < .05) and ROC curve analyses. Total correct and dyad scores were the most effective scoring variables, although there were not statistically significant differences between these and the longer strings of responses. Conclusion(s): The findings provide support for the continued use of total correct scores and dyad scores on the PASAT as predictors of overall cognitive functioning for patients with multiple sclerosis. Longer strings of consecutive responses may be too difficult for many MS patients to achieve, which likely contributed to their limited usefulness for this clinical sample.