ABSTRACT
Contrary to popular mythology, neuropsychologists do more than administer tests. When evaluating patients, neuropsychologists rarely have at their disposal a single “gold standard” test that clinches the diagnosis-whether it is brain dysfunction or malingering. In addition to the neuropsychological test results, the clinician is inundated with a plethora of information (e.g., the patient’s history, physical examination findings, laboratory results, and neuroimaging data). The dilemma is what to do with all of these data. Clinical judgment figures keenly in managing and interpreting this information as part of the diagnostic process. But how accurate are the clinical judgments of most neuropsychologists? This chapter will not attempt to answer this question directly, but will focus instead on: (1) discussing the limitations of clinical judgment, (2) the absolute need to use explicit quantitative methods in the diagnostic process, and (3) potential remedies and their limitations.
