Factor structure and validity of composite scores resulting from a computerized cognitive test battery in healthy adults and patients with primary brain tumors

Computerized neuropsychological test batteries (CNTs), such as Central Nervous System Vital Signs (CNS VS), are increasingly used for measuring cognitive functioning, but empirical evidence of how they measure cognition is scarce. We investigated the factor structure of CNS VS using exploratory factor analyses four samples: healthy adults (n = 169), patients with meningioma (392), low-grade glioma (99), and high-grade glioma (247). We tested model fit and investigated measurement invariance. Differences in factor interpretation existed between healthy participants and patients. Factor structures among patient groups were approximately the same but differed in non-zero loadings. Overall, factor structures largely did not support the “clinical domains” provided by CNS VS for clinical interpretation. Confirmatory models did not have a good fit, and measurement invariance could not be established. Our results indicate that (weighted) sum scores of CNS VS results may lack validity. We recommend researchers and clinicians to use scores on individual test measures.