30| The NIH Toolbox – A Conversation With Dr. Julie Hook

There is a benefit to developing computerized test batteries that can be used across large, longitudinal epidemiologic studies and prevention/intervention trials to facilitate comparison and harmonization across studies.  The National Institute of Health (NIH) Toolbox is a royalty-free battery of tests designed to measure cognitive, sensory, motor, and emotional functioning that can be used across the lifespan and leverages Item Response Theory (IRT).  Over 250 researchers from 80 institutions contributed to the scientific and psychometric development of the NIH toolbox.  Today we bring you our discussion with Julie N. Hook, Ph.D., MBA, ABPP-CN, about the NIH Toolbox and its current and future use to improve collaboration across multisite, international neuropsychological studies, in addition to potential clinical applications.

A pdf of the transcript for this episode is available here.

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Topics Covered (with time stamps)

  • Background on Item Response Theory (1:33)
  • History of the NIH Toolbox (8:26)
  • Hook’s involvement in development of the NIH Toolbox and current role (9:44)
  • What is meant by “common currency” (11:15)
  • How are data exported and stored across studies (12:04)
  • The importance of common data elements across multisite studies (13:10)
  • Advantages of the NIH Toolbox over a typical clinical battery (14:25)
  • Item Response Theory and the Toolbox (25:54)
  • Validation procedures and normative groups for the NIH Toolbox (17:10)
  • Which languages are the Toolbox offered in? (19:13)
  • Who can use the Toolbox? (21:05)
  • International availability of the Toolbox (24:03)
  • How cognitive tests were selected for the Toolbox (26:05)
  • NIH Toolbox core and supplemental tests (28:37)
  • Research to support predictive validity of the Toolbox (31:07)
  • Tests used to differentiate between cognitively normal, MCI, and dementia (33:53)
  • How Toolbox measures compare in sensitivity/specificity to traditional neuropsychological tests (35:11)
  • How the Toolbox fares in measuring high and low functioning individuals (37:06)
  • NIH Toolbox and longitudinal data collection (40:40)
  • The emotional functioning battery (42:29)
  • Definition of the RDoC (46:16)
  • New feature of the Toolbox: iPad delivery (47:32)
  • Using the Toolbox in a clninical setting (49:59)
  • How to learn to administer and score the Toolbox (51:51)
  • Flexible administration (54:49)
  • Cost (56:06)
  • Health Measures, PROMIS, Neuro-QoL, and other standardized questionnaires (57:26)
  • Upcoming changes to the Toolbox (1:00:45)
  • Professional development advice from Dr. Hook (1:03:17)
  • What is it like to work at PAR as a neuropsychologist? (1:06:43)
  • What would Dr. Hook improve about the field of neuropsychology? (1:09:26)
  • What advice does Dr. Hook think is important for trainees? (1:10:51)

About Julie

Dr. Hook is a Research Associate Professor in the Department of Medical Social Sciences at the Northwestern University Feinberg School of Medicine, and is Product Manager of the NIH Toolbox®.  She participates in grant funded research and directs the marketing efforts and strategic direction for the NIH Toolbox.  Her interests in test development and combining innovative technologies to assist in neuropsychological assessment has led her to positions in both academia and industry.  She was previously an Assistant Professor at Rush University (Chicago, IL) and worked in R & D at Psychological Assessment Resources (PAR; Lutz, FL), both a Project Director and Manager of Quality Assurance.  While working in Medical Innovation for Design Interactive, an SBIR-funded human factor engineering company (Orlando, FL), she led a number of innovative DoD grants aimed at incorporating technology (e.g., virtual reality, eye-tracking, and machine learning) into medical practice and training.


Selected References

  • Carlozzi, N. E., Tulsky, D. S., Chiaravalloti, N.D., Beaumont, J. L., Weintraub, S., Conway, K., & Gershon, R. C. (2014). NIH Toolbox Cognitive Battery (NIHTB-CB): The NIHTB Pattern Comparison Processing Speed Test. Journal of the International Neuropsychological Society, 20(6), 630-641. http://dx.doi.org/10.1017/S1355617714000319
  • Dikmen, S. S., Bauer, P. J., Weintraub, S., Mungas, D., Slotkin, J., Beaumont, J. L., . . . Heaton, R. K. (2014). Measuring Episodic Memory Across the Lifespan: NIH Toolbox Picture Sequence Memory Test.Journal of the International Neuropsychological Society, 20(6), 611-619. http://dx.doi.org/10.1017/S1355617714000460
  • Gershon, R. C., Cook, K. F., Mungas, D., Manly, J. J., Slotkin, J., Beaumont, J. L., & Weintraub, S. (2014). The Language Measures of the NIH Toolbox Cognition Battery. Journal of the International Neuropsychological Society, 20(6), 642-651. http://dx.doi.org/10.1017/S1355617714000411
  • Salsman, J., Lai, J.-S., Hendrie, H., Butt, Z., Zill, N., Pilkonis, P. A., . . . Cella, D. (2014). Assessing Psychological Well-Being: Self-Report Instruments for the NIH Toolbox. Quality of Life Research, 23(1), 205-215. http://dx.doi.org/10.1007/s11136-013-0452-3
  • Salsman, J. M., Butt, Z., Pilkonis, P. A., Cyranowski, J. M., Zill, N., Hendrie, H. C., . . . Cella, D. (2013).Emotion Assessment Using the NIH Toolbox. Neurology, 80(11 Supplement 3), S76-S86. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662334/
  • Scott, E. P., Sorrell, A., & Benitez, A. (2019). Psychometric Properties of the NIH Toolbox Cognition Battery in Healthy Older Adults: Reliability, Validity, and Agreement with Standard Neuropsychological Tests. Journal of the International Neuropsychological Society25(8), 857-867.