Measuring cognitive functions: Hurdles in the development of the neuropsychological testing ontology

The NeuroPsychological Testing Ontology provides a set of classes for the representation and annotation of neuropsychological tests and the associated data. These classes are intended to enable the integration of results from a variety of neuropsychological tests that assay similar or overlapping domains of cognitive functioning. Neuropsychological testing is an important component in developing the clinical picture used in the diagnosis of patients with a range of neurological diseases. A core assumption in designing and implementing these tests is that their results provide more than just a description of a patient's behavior. We contend that cognitive functioning assays provide information about the state of the patient's cognitive functioning. Cognitive impairment is, in part, responsible for the patient's observed behavior and can be linked to the medical condition that caused the impairment. Many theoretical and practical issues arise in the course of representing cognitive functioning assays, cognitive functions, and measurements of cognitive functions. In this paper, we discuss how to best represent cognitive functioning assays and the resulting measurements of cognitive functions within the framework of the Ontology for Biomedical Investigations using the handedness assay as a model.