Clinical utility of the TOMMe10 scoring criteria for detecting suboptimal effort in an mTBI veteran sample

Abstract

In the context of diminishing reimbursement and patient access demands, researchers continually refine performance validity measures (PVMs) to maximize efficiency while maintaining confidence in obtained data. This is particularly true for high PVM failure populations (e.g., mTBI patients). The TOMMe10 (number of errors on first 10 TOMM items) is one method this study utilized for classifying PVM performance as pass/fail (fail defined as failure on 2 of 6 PVM scores, pass defined as 0/1 failures). The present study hypothesized that the TOMMe10 would have equitable sensitivity/specificity for identifying non-credible cognitive performance among veterans with mTBI compared to previous research findings and commonly used performance validity measures (e.g., TOMM or WMT). Data were analyzed from 54 veterans assigned to a pass and fail group based on their performance across six recognized PVMs. Results revealed pass/fail groups were not significantly different regarding age, educational, or racial background. ROC analyses found the TOMMe10 demonstrated excellent discriminability (AUC = .803 ±.128), indicating that the TOMMe10 could have clinical utility within an mTBI veteran sample, particularly in conjunction with a second PVM. Specific population limitations are discussed. Additional research should elucidate this measure’s performance with additional populations, including non-veteran mTBI, dementia, moderate-severe TBI, and inpatient populations.

Keywords:

• mTBI
• performance validity
• assessment

Acknowledgements

To my primary research mentor, thank you for the unwavering support from project inception through completion. I am greatly indebted to your time and efforts, without which this paper would not sit where it is today. I would also like to thank my second research mentor for his insights and efforts to sharpen this manuscript.

Disclosure statement

None of the authors have financial conflicts of interest.

Disclaimer

The contents of this publication do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.

Clinical Utility of the TOMMe10 Scoring Criteria for Detecting Suboptimal Effort in an mTBI Veteran Sample