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PubMed1983

The Luria-Nebraska Neuropsychological Battery and the Peabody Individual Achievement Test: a correlational analysis.

A group of 100 neurological, psychiatric, and normal subjects were administered both the Luria-Nebraska Neuropsychological Battery and the Peabody Individual Achievement Test. Correlations between LNNB subtests that tap skills necessary for academic achievement (Reading, Writing, Intellectual Processes, Arithmetic) and corresponding PIAT subtests were high. Correlations between LNNB Localization scales and PIAT scores were also high, with the left Parietal-Occipital Scale showing the highest correlation. Multiple regression analyses generated prediction equations for each PIAT subtest using the LNNB clinical scales.

Achievement↗
PubMed1983

Reliability analyses of the Luria-Nebraska Neuropsychological Battery factor scales by diagnostic group: a follow-up study.

The 30 scales developed from scalewise factor analyses of the items of the Luria-Nebraska Neuropsychological Battery were subjected to internal consistency analyses by means of coefficient alpha for a mixed brain-damaged group and neurologically normal groups of alcoholic and schizophrenic or schizoaffective disorder patients. Thirty-seven per cent of the factor scales failed to reach a 0.70 coefficient alpha level for the mixed brain damaged group, but that figure was reduced to 23% with use of scales based on an orthogonal factor solution for the Receptive Speech scale. Further refinement of the internally consistent factor scales was recommended. Internal consistency values were too low for the factor scales with the alcoholic and psychotic samples to recommend their clinical use with these groups. Methodological issues in the derivation and application of the factor scales were discussed.

Alcoholism↗
PubMed1983

Reliability analyses of the Luria-Nebraska Neuropsychological Battery summary and localization scales by diagnostic group: a follow-up study.

Reliability analyses were computed for the Luria-Nebraska Neuropsychological Battery (LNNB) summary and localization scales using coefficient alpha as a measure of internal consistency. Separate reliability analyses were carried out for a mixed group of brain-damaged patients and neurologically normal groups of psychotic (schizophrenic or schizoaffective disorder) and alcoholic patients. The basic LNNB summary scales appeared to have adequate internal consistency for the three groups sampled. The localization scales were internally consistent for the mixed brain-damaged group, but caution was urged in the use of these scales with the psychotic and alcoholic groups in clinical practice. Their further experimental development was encouraged. Use of ipsative comparison tables based on mixed psychiatric and brain-damaged patients were recommended for clinical use only with mixed brain-damaged patients.

Alcoholism↗
PubMed1983

Empirical evaluation of diagnostic rules for evaluation of Luria-Nebraska Neuropsychological Battery profiles of chronic schizophrenic, schizoaffective, and brain-damaged patients.

Various decision rules have been advanced for evaluation of brain dysfunction with the Luria-Nebraska Neuropsychological Battery in a chronic schizophrenic or schizoaffective disorder psychotic population. The rules of Golden (1981a) produced the highest hit rate of 96% for identification of schizophrenics who had normal neurological examination findings as not brain damaged. Most of the psychotic profile decision rules, however, produced high false negative hit rates with known brain damaged cases. The critical level decision rules (Golden, Moses, Graber, & Berg, 1981) had the highest hit rate (76.7%) with the known brain-damaged sample. Optimal classification of diagnostic groups appeared to be facilitated by use of decision rules that were especially designed for the psychotic and brain-damaged groups, respectively.

Adult↗
PubMed1983

Reliability analyses of the Luria-Nebraska Neuropsychological Battery summary, localization, and factor scales.

Split-half reliability estimates previously reported for the Luria-Nebraska Neuropsychological Battery (LNNB) summary scales have been uniformly high, but their magnitude depends upon the method of item grouping for the half-tests compared. Coefficient alpha was employed in the current study as it gives the mean of all possible split-half values. Alpha reliability coefficients for the LNNB summary and localization scales remained consistently high in current analyses. Alpha reliability coefficients for the LNNB factor scales were quite variable, but most scales have adequate preliminary values for research work and clinical hypothesis confirmation. Four of six receptive speech factor scales were found to be unreliable. Reexamination of their underlying factor structure was suggested.

Adult↗
PubMed1983

An orthogonal factor solution for the receptive speech scale of the Luria-Nebraska Neuropsychological Battery.

Previous principal components factor analyses with oblique rotation to simple structure have produced widely disparate results for the Receptive Speech Scale of the Luria-Nebraska Neuropsychological Battery (LNNB). Four of six scales based on the second factor solution lack internal consistency. A new principal components factor solution was computed with Varimax orthogonal rotation to simple structure for the current study. Three factors emerged that matched the strongest factors of the previous factor solutions closely. Internal consistency of the obtained factors was satisfactory. Theoretical implications and issues for clinical application were discussed.

Adult↗
PubMed1983

Revised ipsative comparison tables for the summary and localization scales of the Luria-Nebraska Neuropsychological Battery.

Revised tables for ipsative comparison of scores on the Luria-Nebraska Neuropsychological Battery (LNNB) were constructed based on coefficient alpha estimates of item consistency for each of the LNNB summary and localization profile scales. Separate ipsative score tables are provided for comparison of a single score with the mean of the basic 11 summary scales, the complete 14-scale summary profile, and each of the eight localization scores with the localization profile. The complementary roles of ipsative, normative, and qualitative item analyses across profiles is discussed as an integrated model for evaluation of LNNB results.

Alcoholism↗
PubMed1984

The profile elevation scale and the impairment scale: two new summary scales for the Luria-Nebraska Neuropsychological Battery.

Two new clinical summary scales have been developed for the Luria-Nebraska Neuropsychological Battery. The scales were constructed in a derivation/ crossvalidation design with a sample of 459 mixed brain impaired patients and 135 non-brain impaired persons. Preliminary evidence suggests that the Profile Elevation scale and the Impairment scale are psychometrically viable, produce additional information to what is offered by the current clinical summary scales, and deserve further investigation. Interpretations are suggested for the two new scales and supported by two neurosurgical case examples. The scales are also expected to offer the possibility of quick screening devices.

Adult↗
PubMed1984

Examination of two decision rules for the global interpretation of the Luria-Nebraska Neuropsychological Battery summary profile.

Rules have been developed to facilitate global interpretive discriminations from the summary profile of the Luria-Nebraska Neuropsychological Battery (LNNB). Two such rules focus on the number of scales above an individual critical level and the range between highest and lowest summary scale t-score. Neither of the criteria have been observed for their relationships with either demographic or treatment variables (e.g., length of hospitalization, type of medication, etc.). The LNNB protocols and demographic and treatment data of 1037 persons were included in this study. The sample included not only brain impaired persons, but also schizophrenic subjects and both medical patients and nonhospitalized normal subjects. A series of analyses indicated that, though the number of scales above critical level and the range may be used in global interpretation of the LNNB profile, the effect of both demographic and treatment variables ought to be taken into account when making an interpretation with an individual patient. More conservative estimates of classification accuracy are reported and several cautions are recommended when applying these decision rules to schizophrenics.

Age Factors↗
PubMed1983

Luria-Nebraska Neuropsychological Battery performance of brain dysfunctional patients with positive or negative findings on current neurological examination.

Two experiments were conducted to investigate the effects of positive or negative neurological examination results on performance on the Luria-Nebraska Neuropsychological Battery in a sample of 229 patients with a history of proven brain damage. The groups did not differ on demographic variables of age, education, or disorder chronicity. The positive and negative neurological examination groups were highly differentiable. A second study demonstrated additional high subgroup differentiability within the positive and negative neurological examination groups as a function of the degree of cognitive deficit demonstrated on the neuropsychological measure. Implications of the results were discussed.

Brain↗
PubMed1999

Limited stage I and II follicular non-Hodgkin's lymphoma: the Nebraska Lymphoma Study Group experience.

The purpose of this study was to evaluate the outcome and prognostic factors of patients with limited stage follicular non-Hodgkin's lymphoma treated prospectively by the Nebraska Lymphoma Study Group (NLSG). Forty previously untreated patients, median age 64 years, with limited stage follicular lymphoma were prospectively treated according to the protocols of the NLSG between January 1980 and December 1990. The follicular large cell type represents 75% of the cases, and 14 of the biopsies also had a diffuse component (composite lymphoma). The initial treatment was radiation therapy (RT) to the involved field in 15 patients, anthracycline-containing combination chemotherapy (CT) in 20, and combined RT and CT in 5. Thirty-seven patients (92.5%) achieved a complete remission (CR). The median follow-up is 120 months (range, 20 to 214). Of the 37 patients achieving a CR, 7 patients are alive in first CR, one died due to sepsis, another because of a myeloproliferative disorder at 77 months following chemotherapy, 6 died because of unrelated causes in first CR. Twenty-two patients relapsed between 1 to 128 months following a CR. The estimated 10-year event-free survival is 21% (95% CI: 7 to 35). Two patients received no or palliative therapy after relapse and both died of progressive disease. Nineteen patients received salvage therapy and 15 achieved a second remission. The median survival after first relapse is 55 months. The estimated 10-year overall survival is 44% (95% CI: 28 to 60). Various factors including sex, histologic subtype, stage, and degree of follicularity do not influence the overall survival or event-free survival. CT with or without RT resulted in a better trend for 10-year event-free survival in stage IA patients compared to RT alone but estimated 10-year overall survival is no different. The overall survival is worse in the > or = 60 age group but this difference is not evident if data is adjusted for cause specific death. In conclusion, limited stage follicular lymphoma has an excellent initial response to radiation therapy or chemotherapy; however the recurrence rate is high and cure is limited.

Adult↗
PubMed1992

Medicare program; Peer Review Organizations: revised scopes of work for the District of Columbia, Puerto Rico, the Virgin Islands, and all states except Delaware, Florida, Missouri, Montana, Nebraska, Nevada, Oklahoma, Rhode Island, South Carolina, Washington, and Wyoming--HCFA. Final notice.

This notice describes requirements for the review activities of Utilization and Quality Control Peer Review Organizations (PROs) under contract extensions of the Scope of Work for the District of Columbia, Puerto Rico, the Virgin Islands and all States except Delaware, Florida, Missouri, Montana, Nebraska, Nevada, Oklahoma, Rhode Island, South Carolina, Washington, and Wyoming. Section 1153(h)(1) of the Social Security Act requires us to publish any new policy or procedure adopted by the Secretary that affects substantially the performance of PRO contract obligations at least 30 days before the date the policy or procedure is to be used. Specifically, this notice describes the way in which PRO contract requirements are changed and explains significant changes in the PRO program (e.g., the way in which cases will be selected for review) and also describes continuing requirements. This notice also implements provisions of the Omnibus Budget Reconciliation Act of 1990.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1992

Hepatic retransplantation: University of Nebraska Medical Center experience.

The lack of an artificial liver makes liver retransplantation a unique, life-saving procedure when all the other alternatives to save a failed graft have been exhausted. On the other hand, the shortage of donors in line with the increasing number of end-stage liver disease patients who are waiting in long recipient lists represents a dilemma and raises the question of most appropriate recipient selection. In this report, we retrospectively analyzed the results of 350 primary, 48 secondary, and 5 tertiary hepatic transplants performed between July 1985 and January 1990 at University of Nebraska Medical Center. The same immunosuppression protocol was used in each case and the maintenance immunosuppressive therapy consisted of a cyclosporine (CyA) and steroids. The overall survival rate of 80.5% at 1 year which was achieved in the primary grafting group was significantly better than the secondary grafting group (63.0%, p less than 0.05). However, this difference was not significant in pediatric patients and their rates were 73.8% and 71.6% in primary and secondary grafting groups, respectively. When the retransplanted patients were considered as deaths unless secondary grafting was performed, the overall patient survival rate of 69.7% in primary grafting group at 1 yr increased to 77.8% in the retransplanted group and this difference was significant (p less than 0.05). Blood loss and operating time were found to be lower in the retransplanted group. Furthermore, the decrease of the operating time in the retransplanted pediatric patients reached statistical significance (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Perceived core procedural skills for Nebraska family physicians.

We conducted a mail survey of 287 practicing family physicians, 22 family practice faculty, and 60 family practice residents in both rural and urban Nebraska concerning their perceptions of "core" procedures in family medicine and their perceived competency in performing them. Final response rate was 45%. There was general agreement concerning what constituted the core procedures in family medicine, although several newer procedures, such as flexible sigmoidoscopy, provoked more controversy. Rural physicians were more likely to classify intrauterine device insertion, endometrial biopsy, and cervical biopsy as core procedures than their urban counterparts. As expected, whether a physician performed a procedure related directly to his reported competence in performing it. However, there were discrepancies between perceived training during residency and current practice for control of nasal hemorrhage, aspiration of breast mass, flexible sigmoidoscopy, endometrial biopsy, and joint aspiration. Faculty programs for teaching procedural skills, standards for documenting competence, and systems for ongoing quality assurance should be further developed.

Clinical Competence↗
PubMed1996

An interrater reliability study of the Luria-Nebraska Neuropsychological Battery Form-II quantitative scoring system.

This study provides information on the interrater reliability of the quantitative scoring system of the Luria-Nebraska Neuropsychological Battery Form II (LNNB-II). The accuracy of each rater following a training procedure was also evaluated. Six college students served as raters, and participated in a 20-22-hour training procedure. This training procedure utilized a protocol similar to one used in previous interrater reliability studies performed with Form I. Following the training procedure, raters were asked to score two videotaped LNNB-II administrations in which a confederate portrayed test performance that was relatively straightforward to score, as well as more ambiguous test performance. Excellent interrater agreement and accuracy were found on the quantitative scoring on both tapes. Implications for training in administration and scoring are discussed.

Journal Article↗
PubMed1994

Modal profiles for the Luria-Nebraska Neuropsychological Battery.

Modal Profile Analysis was used to cluster subjects on the clinical scales of the Luria-Nebraska Neuropsychological Battery, Form I (LNNB). The analysis produced 22 modal profile types, of which seven were replicated in multiple samples of subjects with single criterion diagnoses. Subjects who had been assigned to modal types according to their correlations with the modal profiles were more similar to the modal profile of their assigned groups than to other modal profiles. Assigned subjects were more likely to belong to their assigned group than to other groups and were more similar to other subjects who had been assigned to the same group than to subjects assigned to other groups. Eighty-two percent of subjects in the derivation sample were assigned empirically to a modal profile group; 77% of subjects in a cross-validation sample were assigned to a modal profile group. The discussion focuses on the potential research and clinical use of the modal LNNB profiles.

Journal Article↗
PubMed1989

Utility of the Luria-Nebraska Neuropsychological Battery-Children's Revision in the evaluation of reading disabled children.

The Luria-Nebraska Neuropsychological Battery-Children's Revision (LNNBCR) was used to investigate differences between reading disabled (RD) and academically normal children. The groups of 32 subjects each were equivalent with regard to age, sex, race, IQ, and SES of primary wage earner in the family. RD subjects, all of whom had been identified as learning disabled by the school, were moderately to severely impaired in reading, but not in math. Performance of the groups was significantly different on the battery as a whole and on an abbreviated form of the battery which excluded scales composed of items measuring language, reading, and arithmetic. With the abbreviated battery, the largest group differences were found on the Rhythm scale. It is hypothesized that poor performance on the Rhythm scale may reflect impaired auditory processing, which has a negative impact on the development of basic skills required for reading. A stepwise discriminant function analysis using the abbreviated battery correctly identified 84% of subjects. Evidence supporting discriminative validity of two methods of identifying RD children was found. Performance on an Experimental scale composed of nonreading items presumed to assess the integrity of areas of the brain mediating basic reading skills was no worse than on an equivalent randomly selected pool of items. The LNNB-CR may be a potentially valuable instrument for investigating neuropsychological differences between RD and normal children in that it provides relevant information to educators who must formulate remediation programs for RD children.

Journal Article↗
PubMed1987

Classification with the Luria-Nebraska neuropsychological battery: an application of cluster and ipsative profile analysis.

A sample of 114 subjects, 23 with predominantly left hemisphere brain damage, 25 with predominantly right hemisphere brain damage, 26 with diffuse brain damage, and 40 with adult learning disability were administered the Luria-Nebraska Neuropsychological Battery (LNNB). The clinical scale data were cluster analyzed and subjected to an ipsative analysis of the cluster profiles. A four cluster solution was utilized. It was found that while stable clusters were produced, they were relatively unrelated to actual diagnoses. The first cluster had a normal mean profile, the second reflected specific language impairment, the third, nonverbal skill, memory, and intellectual impairment and the fourth, generalized impairment. The results were discussed in terms of the capacity of the LNNB to generate meaningful neuropsychological profiles.

Journal Article↗