A psychometric comparison of automated neuropsychological assessment metrics with laptop and tablet administration.

Abstract

Objective: Determine whether Automated Neuropsychological Assessment Metrics administered with laptop and tablet platforms produces comparable scores. The study quantified the direction and magnitude of differences using a clinically relevant analytical approach.

Method: Randomized, within-subjects, counterbalanced, repeated-measures study with 302 active-duty service members. Participants completed the 10-subtest battery in two consecutive sessions (Tablet-Laptop, Laptop-Tablet, Tablet-Tablet, and Laptop-Laptop). Analyses included between-group comparisons, within-subject change, and Reliable Change Index base rates.

Results: Laptop scores were significantly higher than tablet scores on 9 of 10 subtests, with effect sizes from d = 0.11 to 1.15. Within-subjects analyses indicated a consistent pattern of performance declines in the Laptop-Tablet Group and improvements in the Tablet-Laptop Group. Reliable Change Index base rates showed that 73% of participants in the Laptop-Tablet Group reliably declined on ≥2 subtests versus 10% in the Tablet-Laptop Group. After correcting tablet controller timing artifacts, effects on fast reaction time (RT) tasks were substantially attenuated, while effects on learning-, memory-, and accuracy-based subtests remained significant with large effect sizes. The Laptop-Tablet Group decline rate decreased from 73% to 57% but remained 4 times the same-platform reference rate.

Conclusion: Tablet and laptop scores may not be interchangeable. Hardware timing corrections attenuated effects on fast RT subtests but did not reduce effects on accuracy-based measures, indicating factors beyond RT measurement error contribute to cross-platform differences. Interpreting tablet-based administration with laptop-based normative data or baselines could misclassify examinees. Until validated tablet-specific interpretive criteria are established, cross-platform comparisons should be avoided.