The Mesulam Cancellation Test is a low cost, quick measure used to screen for hemispatial inattention. The task is also useful for observing a patient's organizational approach. We developed a method to quantify the organizational strategy used by patients in completing this visual scanning task. In this study, we evaluated the reliability of the new method. Participants were 40 patients seen in an outpatient neuropsychology clinic. The 34 men, 5 women, and 1 transitioning individual had a mean age of 49 (SD = 13.94), and mean education of 13.59 years (SD = 2.15). Two raters blinded to patient information provided independent ratings of organization using our new scoring method. Scores ranged from 1 to 5 based on increasing organization. Cohen's weighted Kappa and Spearman's rank order correlation indicated good interrater reliability (Κ(weighted) = .84; rs = .89). The average absolute difference between the raters was .25 (SD = .54). We also found preliminary evidence for the validity of the organizational measure. This study supports the reliability of this new embedded measure of organization. A next step will be to gather normative data, to further establish its validity, and to assess the reliability of the scoring system with other cancellation tests.
Keywords: Boston process; cancellation test; neuropsychology; organization; reliability.