Neuropsychological Measures in the Arab World: A Systematic Review

Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement--a reporting guideline published in 1999--there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.

Clinical neuropsychology has frequently considered visuospatial and non-verbal tests to be culturally and educationally fair or at least fairer than verbal tests. This paper reviews the cross-cultural differences in performance on visuoperceptual and visuoconstructional ability tasks and analyzes the impact of education and culture on non-verbal neuropsychological measurements. This paper compares: (1) non-verbal test performance among groups with different educational levels, and the same cultural background (inter-education intra-culture comparison); (2) the test performance among groups with the same educational level and different cultural backgrounds (intra-education inter-culture comparisons). Several studies have demonstrated a strong association between educational level and performance on common non-verbal neuropsychological tests. When neuropsychological test performance in different cultural groups is compared, significant differences are evident. Performance on non-verbal tests such as copying figures, drawing maps or listening to tones can be significantly influenced by the individual's culture. Arguments against the use of some current neuropsychological non-verbal instruments, procedures, and norms in the assessment of diverse educational and cultural groups are discussed and possible solutions to this problem are presented.

The purpose of this research was to develop, standardize, and test the reliability of a short neuropsychological test battery in the Spanish language. This neuropsychological battery was named "NEUROPSI," and was developed to assess briefly a wide spectrum of cognitive functions, including orientation, attention, memory, language, visuoperceptual abilities, and executive functions. The NEUROPSI includes items that are relevant for Spanish-speaking communities. It can be applied to illiterates and low educational groups. Administration time is 25 to 30 min. Normative data were collected from 800 monolingual Spanish-speaking individuals, ages 16 to 85 years. Four age groups were used: (1) 16 to 30 years, (2) 31 to 50 years, (3) 51 to 65 years, and (4) 66 to 85 years. Data also are analyzed and presented within 4 different educational levels that were represented in this sample; (1) illiterates (zero years of school); (2) 1 to 4 years of school; (2) 5 to 9 years of school; and (3) 10 or more years of formal education. The effects of age and education, as well as the factor structure of the NEUROPSI are analyzed. The NEUROPSI may fulfill the need for brief, reliable, and objective evaluation of a broad range of cognitive functions in Spanish-speaking populations.