Variation and interactional non-standardisation in neuropsychological tests: The case of the Addenbrooke’s Cognitive Examination.

TY - JOUR

T1 - Variation and interactional non-standardisation in neuropsychological tests: The case of the Addenbrooke’s Cognitive Examination.

AU - Jones, Danielle

AU - Drew, Walter Paul

AU - Jackson, Clare

AU - Wilkinson, Ray

N1 - This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.

PY - 2019/8/2

Y1 - 2019/8/2

N2 - The Addenbrooke’s Cognitive Examination (ACE-111) is a neuropsychological test used in clinical practice to inform a dementia diagnosis. The ACE-111 relies on standardized administration so that patients’ scores can be interpreted by comparison with normative scores. The test is delivered and responded to in interaction between clinicians and patients, which places talk-in-interaction at the heart of its administration. In this article, Conversation Analysis (CA) is used to investigate how the ACE-111 is delivered in clinical practice. Based on analysis of 40 video/audio-recorded memory clinic consultations in which the ACE-111 was used, we have found that administrative standardization is rarely achieved in practice. There was evidence of both 1) interactional variation in the way the clinicians introduce the test, and 2) interactional non-standardization during its implementation. We show that variation and interactional non-standardisation have implications for patients’ understanding and how they might respond to particular questions.

AB - The Addenbrooke’s Cognitive Examination (ACE-111) is a neuropsychological test used in clinical practice to inform a dementia diagnosis. The ACE-111 relies on standardized administration so that patients’ scores can be interpreted by comparison with normative scores. The test is delivered and responded to in interaction between clinicians and patients, which places talk-in-interaction at the heart of its administration. In this article, Conversation Analysis (CA) is used to investigate how the ACE-111 is delivered in clinical practice. Based on analysis of 40 video/audio-recorded memory clinic consultations in which the ACE-111 was used, we have found that administrative standardization is rarely achieved in practice. There was evidence of both 1) interactional variation in the way the clinicians introduce the test, and 2) interactional non-standardization during its implementation. We show that variation and interactional non-standardisation have implications for patients’ understanding and how they might respond to particular questions.

KW - Conversation Analysis, Communication, Addenbrooke’s Cognitive Examination, Standardization, and Administration

M3 - Article

SN - 1049-7323

JO - Qualitative Health Research

JF - Qualitative Health Research

ER -