Brief and cost-effective tool for assessing verbal learning in multiple sclerosis: Comparison of the Rey Auditory Verbal Learning Test (RAVLT) to the California Verbal Learning Test – II (CVLT-II)

BACKGROUND The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is a common cognitive screening tool. However, administration and scoring can be time-consuming, and its use of proprietary subtests like the California Verbal Learning Test - II (CVLT-II) is financially limiting. Use of the non-proprietary Rey Auditory Verbal Learning Test (RAVLT) may be provide a valid alternative. OBJECTIVES To compare the RAVLT and CVLT-II in terms of diagnostic accuracy for detecting cognitive impairment, and to determine optimal cut-scores for the RAVLT. METHODS 100 participants with MS completed the five learning trials from the RAVLT and CVLT-II. Receiver operating characteristic analyses were used to compare the measures' sensitivities, specificities, positive predictive values (PPV) and negative predictive values (NPV), and to identify optimal cut-scores. RESULTS Using a criterion of 1.5 SD below the normative sample mean, the RAVLT showed fair to good (κs = 0.21-0.41) agreement with the CVLT-II. A cut-score of 12 on Trials 1 + 2 of the RAVLT showed fair sensitivity (75%) and specificity (76%) and did not differ significantly from the CVLT-II (p > .05). CONCLUSIONS Performance on initial learning trials of the RAVLT may provide a brief, valid, and cost-effective alternative to the CVLT-II for screening verbal learning impairments in MS.