Estimating the Predictive Value of the Test of Memory Malingering: An Illustrative Example for Clinicians

Recent years have witnessed an explosion in the amount of research literature dedicated to the identification of symptom exaggeration and/or malingering in neuropsychological assessments. Additionally, there is now a growing literature devoted to estimating the base rates of symptom exaggeration/malingering in a range of populations and settings. However, very little literature has been devoted to estimating the positive predictive value (PPV) or negative predictive value (NPV) of these assessment devices and/or strategies. The current project was conducted to provide an illustrative example of how to use the research literature to calculate both PPV and NPV in everyday clinical practice. When the Word Memory Test (WMT) was used as the "gold standard" to which the Test of Memory Malingering (TOMM) was compared, the TOMM achieved very high PPV (.98) and acceptable NPV (.78). How to incorporate the strategy used into clinical practice is discussed.