ANAM FAQ
What is ANAM4™?
ANAM4™ - The Automated Neuropsychological Assessment Metrics, Version 4 – is a library of computer-based assessments of cognitive domains including attention, concentration, reaction time, memory, processing speed, and decision-making. ANAM4 provides clinicians and researchers with data to evaluate an individual’s neurocognitive status at a point-in-time and changes in cognitive status over time. ANAM4 is the most recent version of ANAM, a product licensed exclusively by the U.S. Army for development and commercialization and available exclusively from Vista LifeSciences.
ANAM4 includes all research and development from previous versions of ANAM initially developed in the Department of Defense and licensed exclusively through the U.S. Army Technology Transfer program for development into a reliable, repeatable and broadly-available assessment technology.
ANAM4 now includes twenty-two assessments that can be grouped into flexible or standardized batteries that are highly sensitive to cognitive change associated with injury (e.g., trauma, blast) illness (e.g., degenerative disease), exposure (e.g., toxin), risk factors (e.g., heat/cold, sleep loss, fatigue), and intervention (e.g., medication, rehabilitation). Scientists working in varied fields of healthcare and human factors research have identified ANAM4 batteries most useful in their topic-specific research.
Why use automated assessment?
In the 1980s, researchers and scientists began to use personal computers to automate cognitive assessments that historically had been presented by electro-mechanical devices or by clinicians using paper-and-pencil and a stopwatch. When carefully programmed, personal computers can measure an individual’s responses with sub-second accuracy. ANAM was able to implement many tests in a highly precise, sensitive, and repeatable fashion. The Department of Defense, FAA, and NASA were among the earliest government agencies to use automated assessment, including ANAM.
ANAM is not diagnostic. It provides valuable information to clinicians. The ability of computers to present traditional neuropsychological assessment stimuli and measure respond with second accuracy provides valuable information to clinicians.
What assessments modules does ANAM4 include?
ANAM4 does not measure intelligence, but provides an assessment of neurocognitive functions or "cognitive domains." Assessment modules include:
- Symptoms Scale
- 2-Choice Reaction Time
- Code Substitution (Learning, Immediate, and Delayed)
- Demographics Module
- Effort Measure
- Go/No-Go (Executive Function)
- Logical Relations- Symbolic Manikin
- Matching Grids
- Matching to Sample
- Mathematical Processing
- Memory Search
- Mood Scale II –Revised
- Procedural Reaction Time
- Pursuit Tracking
- Running Memory- Continuous Performance Task
- Simple Reaction Time
- Sleepiness Scale
- Spatial Processing – Sequential and Simultaneous
- Stroop
- Switching
- Tap Left/Tap Right
- Tower Puzzle
How are ANAM4 results accessed by clinicians and researchers?
ANAM4 includes the ANAM4 Performance Report (APR), which provides the clinician with full reports on current neurocognitive status for the assessment battery and comparisons to previous assessment sessions, as well as to various reference/norm groups. ANAM4 also includes the ANAM4 Data Extraction and Presentation Tool (ADEPT), which provides clinicians and researchers the ability to easily select, organize, and display, ANAM4 data in spreadsheet form and transfer ANAM4 data to common statistical and graphics packages.
Who interprets ANAM4 results?
In clinical applications, the interpretation of ANAM4 assessment results should be conducted by qualified medical professionals, such as a clinical psychologists, neuropsychologists or physicians with training in psychological testing principles, test administration procedures, and clinical test interpretation. ANAM4 is not a diagnostic. It provides information to the clinician regarding neurocognitive functioning that should be considered together with other clinically-relevant information to assist in medical decision-making.
How are baseline assessments used in healthcare and performance readiness?
Baseline cognitive assessment can be compared with assessments made at a later time to identify cognitive changes. Clinicians in many fields of medicine and human performance measurement use baseline and follow-up assessments as one element of information in an overall assessment of health or performance status.
How long does an ANAM4 assessment take to complete?
The length of the test depends on the number of assessment modules included in the battery. As an example, the standard ANAM4 battery used by the U.S. Department of Defense for cognitive measurement takes approximately 20-25 minutes to administer to 95% of test takers. The cognitive domain measures in this battery have been refined over a decade to identify those most sensitive and specific to brain injury.
How is ANAM4 administered?
Recommended ANAM4 administration procedures follow the general guidelines of the American Psychological Association (APA) for distribution and administration of psychological tests. In a group testing environment, verbal directions are recommended to supplement written instructions. This assists test takers with varied reading capabilities.
ANAM4 can be administered by qualified professionals who have training in psychological testing principles and test administration procedures. Training for proctors is offered through Vista LifeSciences. No specialized equipment is required to run ANAM. Requirements include simply:
- A desktop, laptop, or tablet PC
- Windows Vista, XP, or 2000 operating system
- Mouse
ANAM4 software includes a timing mechanism to insure SRT accuracy across computer platforms and supports immediate analysis and report generation.
Is there a "practice effect" when individuals take the ANAM4 multiple times?
"Practice effect" is the change in assessment performance that occurs when an assessment is repeated multiple times in succession. While almost any performance-based test will exhibit some "practice effect," ANAM4 was designed to have minimal "practice effect." ANAM4 software provides randomized stimuli across tests sessions, creating an almost limitless number of alternative forms and combinations to facilitate repeated-measures testing.
Clinical and research protocols for cognitive testing, especially automated testing, differ in their management of "practice effect". Researchers often repeat a test many times to achieve "asymptotic" performance levels on the test prior to administering treatment and post-treatment test trials. Asymptotic performance is typically defined as performance absent most learning effects. This protocol provides a good method for assessing very subtle changes in function.
In clinical use of automated neuropsychological assessments, clinicians typically do not seek "asymptotic" performance levels. They attempt to obtain a baseline that represents a good estimation of "first time exposure" to a test. The baseline represents a "comparative assessment point." The assumption is that the post-injury assessment will probably not be repeated for period of time so the post-injury assessment will be more like a "first time exposure."
What software language and development standards are used for ANAM4 development?
ANAM4 is written in C++ and C# and uses Web Services to utilize IP protocols over the internet. All assessment responses are measured in sub-seconds on computer hardware. The ANAM4 system development lifecycle is managed according to best industry practices.
ANAM4 is backward compatible with earlier versions of ANAM assessment modules wherever possible. Appropriate engineering and quality assurance practices are central to ANAM4 development and have been used to preserve the integrity of ongoing longitudinal studies.
Is ANAM research ongoing?
ANAM is unlike other commercial cognitive assessment software in its research history and research approach. ANAM is based on decades of laboratory and clinical research and referenced in more than 300 peer-reviewed independent research studies and has been used by some of the world’s most prestigious research institutions such as NASA and the FAA.
ANAM has a long and continuous history of research in the Department of Defense, including sports concussion studies at West Point and TBI assessment during Ft. Bragg Paratrooper training.
Through these programs and other programs, nearly one million ANAM assessments have been collected. ANAM has the most comprehensive military research and clinical application records of any cognitive assessment technology.
The Archives of the National Academy of Neuropsychology, the official journal of the National Academy of Neuropsychology, published a special edition of its journal focused exclusively on ANAM in 2007.
Notes on the History of ANAM Development….
Judgment, memory, mood, and general cognitive status are critical elements in an individual’s performance in simple daily tasks and complex work.
During his tenure in the 1980s as Director of the Office of Military Performance Assessment Technology (OMPAT) and Director of the Military Operational Medicine Research Program, Dr. Fred Hegge recognized the importance of cognitive health and the need for a consistent and well-developed approach to cognitive assessment. He and his team worked with a diverse set of neuropsychological testing tools, including the Walter Reed Performance Assessment Battery, a standardized set of cognitive assessment tools that could effectively be used in diverse conditions including varied climates, altitudes and toxic conditions.
Dozens of the finest neuropsychological and human performance researchers and scientists working for federal agencies or using ANAM with approval from the U.S. Army contributed to ANAM development.