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The NIH Toolbox®: Setting a standard for biomedical research

Molly Wagster
Chief, Behavioral and Systems Neuroscience Branch,
Division of Neuroscience (DN)

Imagine having access to more than 100 measures that can be used as a common currency across diverse study designs and settings. Imagine being able to evaluate participants in clinical studies with age-appropriate measures. And, imagine being able to access this system through a tablet computer.

You don’t have to imagine all this, because it exists and is available in the NIH Toolbox®.

The NIH Toolbox® for Assessment of Neurological and Behavioral Function is a set of brief, psychometrically sound measures to assess motor, emotional, sensory, and cognitive function in people aged 3 – 85. It provides 104 well-validated measures and normative data in English and Spanish.

Since its debut in 2012, the NIH Toolbox® has been used in over 600 studies, including the NIH Human Connectome Project and the National Children’s Study, as well as in several large cohort studies of traumatic brain injury. Studies to date have run through Assessment CenterSM, a web-based entry to the NIH Toolbox® and other NIH-supported measurement systems such as PROMIS® and Neuro-QoL.

Today, I want to reintroduce this valuable resource, and to let you know we’re adding a great new feature.

NIH Toolbox for iPad!

In response to demands for a more portable assessment system, an iPad version of the NIH Toolbox® is now available. Created by the development team at Northwestern University, this new version was just introduced over the summer. The measures are now available to researchers and clinicians through an app in the iTunes App Store. You’ll need Wi-Fi capacity for initial installation of the app, but you won’t need an internet connection to use it.

The NIH Toolbox®, developed under the auspices of the NIH Blueprint for Neuroscience Research, includes several measures that may be of particular interest to aging researchers. For example, you can assess balance with an iPod used in conjunction with the iPad. The system transmits 15,000 data points in 7 minutes or less, automatically analyzing the data in real time. Emotional function subdomains can be assessed in as little as a minute with a computer adaptive testing approach. This provides self-report assessment on 20 constructs including emotional support, loneliness, self-efficacy, meaning, and purpose, as well as perceived stress. Measures of cognition span multiple domains, including speed of processing and inhibitory control; composite scores of cognitive function and crystallized cognition can be generated.

Why does it matter what we use to measure?

Over the years, researchers and psychometricians have produced numerous excellent assessment tools to measure emotional, sensory, motor, or cognitive performance. However, many of these tools are now outdated, sometimes used inappropriately, or not used uniformly. This use of different measures to assess similar traits has interfered with our ability to compare data readily across studies and slowed down the scientific enterprise. Current initiatives such as Big Data to Knowledge and the Precision Medicine Initiative (now known as the All of Us Research Program) underscore the need for us to use common, standard measures in research to maximize the yield from very large, expensive studies with minimal increase in subject burden and cost.

We invite researchers around the world to access the new iPad version of the NIH Toolbox® and try out the measures that appeal to you. Accurate, uniform measurement matters—to bring common currency to studies and, ultimately, to advance global public health.