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Cross-national harmonization of neurocognitive assessment across five sites in a global study.

Open access
Batistuzzo, Marcelo C., Sheshachala, Karthik, Alschuler, Daniel M., Hezel, Dianne M., Lewis-Fernández, Roberto, de Joode, Niels T., Vriend, Chris, Lempert, Karolina M. +8 more·2023·Neuropsychology

Abstract

OBJECTIVE: Cross-national work on neurocognitive testing has been characterized by inconsistent findings, suggesting the need for improved harmonization. Here, we describe a prospective harmonization approach in an ongoing global collaborative study. METHOD: -Back, Tower of London (ToL), Stop Signal task (SST), Risk Aversion (RA), and Intertemporal Choice (ITC) tasks were administered to 221 individuals from Brazil, India, the Netherlands, South Africa, and the USA. Prospective harmonization methods were employed to ensure procedural similarity of task implementation and processing of derived task measures across sites. Generalized linear models tested for between-site differences controlling for sex, age, education, and socioeconomic status (SES). Associations with these covariates were also examined and tested for differences by site with site-by-covariate interactions. RESULTS: -Back (sex, age, education, and SES), ToL (sex, age, and SES), SST (age), and ITC (SES) showed associations with covariates. CONCLUSIONS: Four out of the five sites showed only small between-site differences for each task. Nevertheless, despite our extensive prospective harmonization steps, task score performance deviated from the other sites in the Netherlands site (on four tasks) and the India site (on one task). Because the procedural methods were standardized across sites, and our analyses were adjusted for covariates, the differences found in cognitive performance may indicate selection sampling bias due to unmeasured confounders. Future studies should follow similar cross-site prospective harmonization procedures when assessing neurocognition and consider measuring other possible confounding variables for additional statistical control. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Verified 2026-10-09 · 1 reference not checked yet

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Written from the paper’s full text.

TL;DR

Prospective harmonization of five neurocognitive tasks across Brazil, India, the Netherlands, South Africa, and the USA in 221 healthy adults yielded mostly small between-site differences, but the Netherlands site differed on four tasks and India on one. The authors interpret residual differences as likely selection/sampling bias or unmeasured confounders rather than harmonization failure.

Key findings

  • The Netherlands site had higher accuracy on N-back total correct (87% vs. Brazil 78%, India 76%, South Africa 80%, USA 84%) and ToL total correct (92% vs. Brazil 86%, India 87%, South Africa 88%, USA 89%); the USA also outperformed India on N-back.
  • The Netherlands and USA sites had faster go reaction times on the SST than the other three sites; no site differences were detected in SSRT.
  • The Netherlands showed lower delay discounting on the ITC (log k −5.47 vs. −4.55 overall; 54% delayed choices vs. 43% overall), and India showed more risk aversion on the RA task (log α −0.65 vs. −0.33 overall; 32% risky choices vs. 47% overall).
  • After dropping the Netherlands (N-back, ToL, ITC, SST) and India (RA), between-site effect sizes were generally small (partial η² < 0.05; e.g., N-back < 0.042, ToL < 0.014), though RA remained significant with partial η² = 0.05 and 0.06. Covariates associated with performance included N-back (sex, age, education, SES), ToL (sex, age, SES), SST (age), and ITC (SES).

Methods

  • Cross-sectional analysis within an ongoing global multi-site OCD study; 221 healthy participants aged 18–50 from Brazil (n = 51), India (n = 34), the Netherlands, South Africa, and the USA. Exclusions included current/lifetime psychiatric disorder other than past major depression or anxiety disorders (if not in the past year), psychotropic medication use, first-degree relative with OCD or tic disorder, IQ < 80, major medical/neurological disorders, and MRI contraindications.
  • Five computerized tasks were administered: Visuospatial N-Back, Tower of London, Stop Signal, Risk Aversion, and Intertemporal Choice. Prospective harmonization included same task versions, forward/backward translation into Afrikaans, Dutch, English, Kannada, and Brazilian Portuguese, a standard operating procedures manual, same laptop/screen settings, E-Prime software (India used E-Prime 3; other sites used E-Prime 2), piloting, monthly neurocognitive working group calls, quality-control exclusions, and purchasing power parity conversion for monetary rewards.
  • Generalized linear models tested site differences unadjusted and adjusted for sex, age, education, and SES (WAMI); random-intercept/slope mixed models tested difficulty slopes; LSD post hoc tests evaluated pairwise site differences; partial eta-squared indexed effect size; Levene’s test assessed variance homogeneity; site-by-covariate interactions were tested. Alpha was 0.05 without multiple-comparison correction; power was at least 80% to detect partial eta squared ≥ 0.0523.

Limitations

  • Stated: sample size of 221 and 34–51 participants per site limits power to detect small effects; no correction for multiple comparisons increases false positives; task order was not counterbalanced; age range 18–50 and IQ > 80 without current/past psychiatric disorders limit generalizability; years of education is not a direct measure of academic achievement; N-back had higher exclusion (17.6%) and exclusion proportions differed by site on N-back and RA; measurement invariance was not tested.
  • Stated: despite harmonization, the Netherlands differed on four tasks and India on one; the authors suggest selection sampling bias or unmeasured confounders and note difficulty ensuring covariates reflect the same construct across sites.
  • Evident from the text: India used E-Prime 3 while other sites used E-Prime 2; COVID-19 protocol modifications occurred mid-study (pre n = 131, post n = 90), with ToL difficulty slope differing pre vs. post; the sample was cross-sectional and restricted to healthy participants, so clinical and broader population generalizability is unknown.

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Registry

Crossref · 10.1037/neu0000838

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Claims the paper makes

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  • Findingown data

    The N-back task showed associations with sex, age, education, and socioeconomic status across sites.

    “Across tasks, regardless of site, the N-back (sex, age, education, and SES), ToL (sex, age, and SES), SST (age), and ITC (SES) showed associations with covariates.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The neurocognitive tasks measure the same cognitive constructs across all five sites despite translation and cultural differences.
  • Findingown data

    The India site showed greater risk aversion on the Risk Aversion task than other sites.

    “and the India site showed more risk aversion than other sites on the RA task.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The neurocognitive tasks measure the same cognitive constructs across all five sites despite translation and cultural differences.
  • Findingown data

    The Tower of London task showed associations with sex, age, and socioeconomic status across sites.

    “Across tasks, regardless of site, the N-back (sex, age, education, and SES), ToL (sex, age, and SES), SST (age), and ITC (SES) showed associations with covariates.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The neurocognitive tasks measure the same cognitive constructs across all five sites despite translation and cultural differences.
  • Findingown data

    Four of the five sites showed only small between-site differences for each task.

    “Four out of the five sites showed only small between-site differences for each task.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neurocognitive tasks measure the same cognitive constructs across all five sites despite translation and cultural differences.
  • Findingown data

    The Netherlands site showed greater tolerance for delayed rewards (lower delay discounting) on the Intertemporal Choice task than other sites.

    “Finally, the Netherlands site also exhibited a higher tolerance for delay discounting than other sites on the ITC”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The neurocognitive tasks measure the same cognitive constructs across all five sites despite translation and cultural differences.
  • May combine two claims. 72
  • Classified as probably not a substantial claim. 34
  • May combine two claims.

    Findingown data

    Despite extensive prospective harmonization, the Netherlands site deviated from other sites on four tasks and the India site deviated on one task.

    “Nevertheless, despite our extensive prospective harmonization steps, task score performance deviated from the other sites in the Netherlands site (on four tasks) and the India site (on one task).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neurocognitive tasks measure the same cognitive constructs across all five sites despite translation and cultural differences.
  • May combine two claims.

    Findingown data

    After controlling for sociodemographic characteristics, the Netherlands was the only site with significantly higher ToL performance compared to the others, which did not differ from one another.

    “After controlling for sociodemographic characteristics, as in the N-back, the Netherlands was the only site with significantly higher performance on the ToL compared to the others, which did not differ from one another.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    No significant associations of RA task scores with any demographic variable or interactions with site were detected at alpha 0.05.

    “No significant associations of RA task scores with any demographic variable or interactions of these associations with the site were detected at an alpha value of 0.05 (Table 3).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    For the ITC variance differences, the USA site had the highest variability and South Africa the lowest.

    “For both, the USA site presented the highest variability, whereas South Africa presented the lowest (see Table S6 for more detail).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    In the N-back, the USA also had higher accuracy than India, while other sites did not differ from one another.

    “The USA also had higher accuracy than India, while the other sites did not differ from one another (Table 2).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    No other demographic variable nor significant site interactions were detected for ITC.

    “no other demographic variable nor significant site interactions were detected.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    For the N-back difficulty slope, the USA slope was significantly less steeply declining than Brazil, India, and South Africa, while other sites did not differ.

    “Furthermore, the USA slope was found to be significantly less steeply declining than Brazil, India, and South Africa, while the other sites did not differ from one another (Table 2, Figure S2).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    India had a lower RA log α value (−0.65 vs −0.33 overall) and nearly a full standard deviation (SD=19) lower average percentage of risky choices (32% in India vs 47% overall).

    “Specifically, India was lower in its log α value (−0.65 in India vs. −0.33 overall) and nearly a full standard deviation (SD = 19) lower in its average percentage of risky choices across trials (32% in India vs. 47% overall).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    In the ToL, between-site differences emerged for difficult loads 3 and 5 (p=0.023 and 0.003), total percentage correct (partial η2=0.070, p=0.004), and difficulty slope (F=5.58, p<0.001).

    “Between site differences emerged for difficult loads 3 and 5 (p-values = 0.023 and 0.003, respectively), for total percentage of correct responses (partial η2 = 0.070, p-value = 0.004), and for the difficulty slope (F-value = 5.58, p-value < 0.001).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    In the ToL, there were no associations with education, but SES was associated with the majority of task variables.

    “There were no associations with education, but socioeconomic status (WAMI) was associated with the majority of variables from this task (Table 3).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The average age of the sample was 30 years, ranging from 26.9 years in India to 32.9 years in the Netherlands.

    “The average age of the sample was 30 years, ranging across sites from 26.9 years in India to 32.9 years in the Netherlands.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    In the ToL, higher SES was associated with higher total percentage correct (β=18.781, p=0.004) and a higher difficulty slope (β=11.503, p<0.001), indicating a less steep decline in accuracy.

    “The total percentage of correct responses (β = 18.781, p-value = 0.004) and the difficulty slope were higher (β = 11.503, p-value < 0.001), indicating a less-steep decline in accuracy for respondents with higher SES.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    In the N-back, significant site differences were observed in the more difficult conditions N=2 and N=3 (p<0.001 and 0.004) and in total percentage correct (partial η2=0.114, p<0.001).

    “In the more difficult conditions (N = 2 and N = 3) significant differences were observed (p-values = <0.001 and 0.004) as well as in the total percentage of correct responses (partial η2 = 0.114, p-value < 0.001)”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    For the ITC, site variance differed for log k (F=3.82, p=0.005) and percentage of delayed choices (F=2.46, p=0.046).

    “the ITC task showed differences for the log k value (F=3.82, p=0.005) and the percentage of delayed choices (F=2.46, p=0.046).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Both main outcomes of the RA task, log α and percentage of risky choices, were significantly different between sites with medium effect sizes (log α partial η2=.09, p=0.001; percentage risky choices partial η2=0.11, p<0.001) after adjusting for demographic variables.

    “Both main outcomes of the RA task, the log α value and the percentage of risky choices, were significantly different between sites with medium effect sizes (log α partial η2 = .09, p = 0.001; percentage of risky choices partial η2 = 0.11, p < 0.001) after adjusting for demographic variables (Table 2, Figure S6).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Several associations were found between task performance and sociodemographic variables across sites, and mainly in the ToL, the association with age and SES differed by site, reflected by an interaction effect.

    “Several associations were found between task performance and sociodemographic variables across sites and, mainly in the ToL, the association with age and SES differed by site, reflected by an interaction effect.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Years of education were highest in Brazil (17.1 years) and lowest in South Africa (14.9 years).

    “Across the sites, the number of years of education was highest in Brazil (17.1 years) and lowest in South Africa (14.9 years).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    For the ToL difficulty slope, the Netherlands had a less steep decline (−4.15) than Brazil, India, and South Africa, but not the USA; the USA also had a less steep decline than Brazil and India.

    “Regarding the difficulty slope, the Netherlands presented a less-steep decline in performance as difficulty increased (−4.15) which was significantly different from Brazil, India, and South Africa sites, but not the USA site; the USA site also had a significantly less-steep decline than the Brazil and India sites (Table 2).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Significant site differences were found for SST go RT (partial η2=0.068, p=0.007), with the Netherlands and USA exhibiting the fastest times.

    “However, we found significant site differences for go RT (partial η2 = 0.068, p-value = 0.007), with the Netherlands and the USA exhibiting the fastest times.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    There was no overall significant effect of age on the ToL difficulty slope (β=−0.047, p=0.109), but there was an age-by-site interaction for the difficulty slope (p=0.002).

    “While there was no overall significant effect of age on the difficulty slope (β = −0.047, p-value = 0.109), there was an age-by-site interaction for the difficulty slope (p-value = 0.002) (Table 3).”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Among the 221 participants, 16 had a past lifetime diagnosis of MDD (7.2%) and 11 had a past lifetime diagnosis of an anxiety disorder (5.0%), totaling 10.0% of the sample.

    “Among the 221 participants, 16 had a past lifetime diagnosis of MDD (7.2%), and 11 had a past lifetime diagnosis of an anxiety disorder (5.0%), totaling 10.0% of the sample.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Post-hoc comparisons showed the N-back total percentage correct site effect was mostly driven by the Netherlands having higher accuracy (87%) than Brazil (78%, p<0.001), India (76%, p<0.001), South Africa (80%, p=0.003), and the USA (84%, p=0.031).

    “Post-hoc comparisons showed that the site effect on the total percentage of correct responses was mostly driven by the Netherlands site which had higher accuracy (87%) than Brazil (78%, p-value < 0.001), India (76%, p-value < 0.001), South Africa (80%, p-value = 0.003), and the USA (84%, p-value = 0.031).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    The same N-back pattern was observed for the difficulty slope, with the USA site also presenting better performance than the other sites.

    “The same pattern was observed for the difficulty slope, with the USA site also presenting better performance than the other sites (Table 2).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Re-running ToL analyses without the Netherlands led to small effect size differences among the remaining four sites (all partial η2<0.014) in all conditions and total percent correct, with only the difficulty slope still differing across sites.

    “Re-running the analyses without the Netherlands data, and making comparisons across the remaining 4 sites, led to an overall small effect size difference (all partial η2 < 0.014) in all conditions and for total percent correct with only the difficulty slope still presenting differences across sites (Table 2).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Dropping the India site led to overall small effect sizes for RA (partial η2=0.05 for log value and 0.06 for percentage risky choices) but still significant (p=0.039 for log α, p=0.011 for percentage risky choices).

    “Dropping the India site and making comparisons across the other four sites led to overall small effect sizes (partial η2 = 0.05 for log value and = 0.06 for the percentage of risky choices) but still significant (p = 0.039 for log α value, p = 0.011 for percentage of risky choices) (Table 2).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Apart from a significant association between go-RT and age (older subjects were slower to respond), there were no associations with demographics or significant interactions by site for the SST.

    “Apart from a significant association between go-RT and age (i.e., older subjects were slower to respond), there were no associations with any demographics or significant interactions by site (Table 3).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    For the N-back difficulty slope, the Netherlands had a significantly less steep declining slope (−10.9) than Brazil (−17.3, p<0.001), India (−18.2, p<0.001), and South Africa (−16.0, p=0.005), but not the USA (−12.3, p=0.448).

    “Similar site-specific effects were found for the difficulty slope such that the Netherlands had a significantly less steep declining slope (−10.9) than Brazil (−17.3, p < 0.001), India (−18.2, p < 0.001), and South Africa (−16.0, p = 0.005), but not the USA (−12.3, p = 0.448).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Both ToL total percentage correct and difficulty slope had an interaction by site (p=0.036 and 0.018, respectively).

    “Both variables also presented an interaction by site (p-values = 0.036 and 0.018, respectively)”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    ToL total percentage correct was negatively associated with age (β=−0.215, p=0.001) and had an age-by-site interaction (p=0.008).

    “Overall task performance (total % correct) was negatively associated with age (β = −0.215, p-value = 0.001) and presented an interaction effect by site (p-value = 0.008)”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    In the ToL, males performed more accurately than females for total percentage correct (β=2.68 percentage points higher in males, p=0.010) and showed less decline in accuracy as difficulty increased (β=1.04, p=0.031).

    “When observing the association between sociodemographic and ToL performance across all sites, males performed more accurately than females for the total percentage of correct responses (β = 2.68 percentage points higher in males, p-value = 0.010) and showed less decline in accuracy as difficulty increased (β = 1.04, p-value = 0.031).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    The ToL difference was present for total percentage correct (also levels 3 and 5) and the difficulty slope, with the USA also presenting better performance on the difficulty slope.

    “The difference was present for the total percentage of correct responses (also levels 3 and 5), and the difficulty slope (in this last variable, the USA site also presented better performance when compared to the other sites).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Post-hoc ITC comparisons found differences were driven by the Netherlands having a significantly lower log k value (−5.47 vs −4.55 overall) and a higher percentage of choices of the larger delayed reward (54% vs 43% overall) than all other sites.

    “Post-hoc comparisons found that site differences were driven by the Netherlands site having a significantly lower log k value (−5.47 Netherlands vs. −4.55 overall) and a higher percentage of choices of the larger, delayed reward (54% Netherlands vs. 43% overall) than all other sites.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Post-hoc inspection indicated the India site significantly differed from the other sites and Brazil had more risk aversion than the Netherlands for both RA measures.

    “Post-hoc inspection indicated that the India site significantly differed from the other sites and that the Brazil site had more risk aversion than the Netherlands site for both measures.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    In the N-back, age (β=−0.242, p=0.015) and education (β=0.729, p=0.037) were associated with total percentage correct, and SES was associated with the difficulty slope (β=18.032, p=0.015).

    “Associations between the task variables and sociodemographic covariates revealed that age (β = −0.242, p-value = 0.015) and education (β = 0.729, p-value = 0.037) were associated with the total percentage of correct responses, whereas SES was associated with the difficulty slope (β = 18.032, p-value = 0.015).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingcitation

    Consistent with previous research, the study found a significant decline in N-back task performance at higher difficulty levels and total score as one ages.

    “Consistent with previous research, we found a significant decline in task performance at higher difficulty levels (and the total score), as one ages (Dobbs & Rule, 1989; Bopp & Verhaeghen, 2020).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Dobbs & Rule, 1989

      Not checked in the free run.

    • cites Bopp & Verhaeghen, 2020

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    After adjusting for covariates, task performance significantly varied across sites, and these differences were attenuated by dropping the Netherlands data.

    “After adjusting for covariates, task performance significantly varied across sites, which was attenuated by dropping the Netherlands data from the analysis.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Both ITC task measures were significantly associated with SES as measured by WAMI, indicating higher SES was associated with lower discount rates (β=−3.047, p=0.016 for log k; β=38.642, p=0.016 for % delayed choices).

    “Apart from a significant association of both ITC task measures with socioeconomic status as measured by the WAMI, indicating that higher SES was associated with lower discount rates (β = −3.047, p-value = 0.016 for log k value and β = 38.642, p-value = 0.016 for % of delayed choices)”
    • Also stated in: § DISCUSSION · plain
      “Across sites, socioeconomic status was associated with temporal discounting, such that higher-SES individuals had lower discount rates.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The proportion of females ranged from 38.2% to 64.6% across sites, with no statistical differences between sites.

    “The proportion of females ranged from 38.2% to 64.6% (Table 1), and there were no statistical differences between sites.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Post-hoc analyses showed Brazil had a strong association between age and a more steeply declining ToL difficulty slope (decrease in accuracy between difficulty levels became steeper by −0.3209 percent per difficulty level and year of age, p<0.001), while the age-slope association in India, Netherlands, South Africa, and USA was not different from zero (p=0.677, 0.262, 0.255, 0.389).

    “Post-hoc analyses showed that the Brazil site showed a strong association between age and more steeply declining slope for higher task difficulty (the decrease in accuracy between difficulty levels becomes steeper by −0.3209 percent per difficulty level and year of age, p-value < 0.001), while the association of age with the difficulty slope in all other sites was not different from zero (India: p”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Across all sites, significant associations were found between ToL performance and sex, age, and SES, with younger and higher-SES males performing better.

    “Across all sites, significant associations were found between performance on the ToL and sex, age, and SES. Specifically, younger and higher-SES males performed better relative to other participants.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    The sample included healthy adults from all five sites, with the largest number in Brazil (n=51) and the smallest in India (n=34).

    “The sample included healthy adults from all five sites, with the largest number in Brazil (n=51) and the lowest in India (n=34; Table 1).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Post-hoc ToL comparisons showed the Netherlands had a higher total percentage correct (92%) than Brazil (86%), India (87%), and South Africa (88%), but not the USA (89%).

    “Post-hoc comparisons between sites revealed that the Netherlands site had a higher total percentage of correct responses (92%) than Brazil (86%), India (87%), and South Africa (88%), but not the USA (89%).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Post-hoc tests for the ToL age-by-site interaction indicated Brazil showed a higher decline in total performance with age than India (p=0.046), the Netherlands (p<0.001), and South Africa (p=0.004), but not the USA (p=0.128).

    “with post-hoc tests indicating that the Brazil site showed a higher decline in total performance than India (p = 0.046), the Netherlands (p < 0.001), South Africa (p = 0.004), but not USA (p = 0.128), as participants got older (Figure 2A).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    More participants met exclusion criteria on the N-Back task, with data available for 82.4% of the sample.

    “More participants met our exclusion criteria on the N-Back task (data available for 82.4%)”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Age was negatively associated with outcomes on the cold tasks (N-back, ToL and SST) but did not affect performance on the choice tasks.

    “age was negatively associated with outcomes in the “cold” tasks (N-back, ToL and SST), while it did not affect the performance on the choices’ tasks.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Site interactions with age and SES were found for several ToL measures, including total percentage correct and difficulty slope, indicating Brazil had the strongest association between older age and decline in performance.

    “Of note, site interactions with age and SES were found for several measures of this task, including the total percentage of correct responses and difficulty slope, indicating that the Brazil site had the strongest association between older age and decline in performance (Figure 2).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Participants in India were significantly more risk-averse compared to participants at all other sites, who did not differ from each other.

    “Our first key finding was that participants in the India site were significantly more risk-averse compared to participants at all other sites, who did not differ from each other.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Variability in both ITC measures differed across sites, being greatest in the USA and lowest in South Africa.

    “we observed variability differences across sites in both ITC measures (with the most variability in the USA and the lowest in South Africa)”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    After adjusting for demographic covariates, only one site differed on each task: the Netherlands on the N-back, ToL, SST and ITC tasks, and India on the RA task.

    “the fact that we encountered differences in only one site for each task evaluated in the study after adjusting for demographic covariates (Netherlands was different for N-back, ToL, SST, and ITC tasks, whereas India was different in the RA task)”
    • Also stated in: § CONCLUSION · plain
      “only the Netherlands (in variables of the N-back, ToL, SST and ITC task) and India (in both variables measures for the RA task) were discrepant after adjusting for demographic covariates.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Because currency differed across sites, a purchasing power parity (PPP) conversion formula was calculated to ensure monetary rewards were appropriately rewarding across currencies and countries.

    “As the currency of monetary reward differed across the sites, a suitable conversion formula based on purchasing power parities (PPP) was calculated to ensure the monetary rewards were appropriately rewarding across currencies and countries”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The stringent (prospective) harmonization approach is considered ideal and involves using identical methods and instruments across studies or sites.

    “The stringent (prospective) approach is considered ideal and consists of identical methods and instruments across studies/sites.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fortier et al., 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    A neurocognitive working group with researchers from each site met monthly by conference call to ensure consistency of the harmonization process and to troubleshoot issues.

    “A neurocognitive working group composed of researchers involved in neurocognitive assessments at each site met monthly over conference calls to ensure consistency of the harmonization process and to troubleshoot any issues.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Independent regional language experts at each site performed forward and backward translation of task instructions, and a native English speaker from the USA site compared the original and back-translated English versions for consistency.

    “Independent regional language experts at each site carried out forward and backward translation of task instructions. For consistency, each site’s original and back-translated English versions were compared by a native English speaker from the USA site.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Quality checks were performed at regular intervals to ensure data quality at each site.

    “Quality checks were performed at regular intervals to ensure data quality at each site.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Prospective harmonization methods were used to ensure that task implementation and processing of derived measures were procedurally similar across sites.

    “Prospective harmonization methods were employed to ensure procedural similarity of task implementation and processing of derived task measures across sites.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study's design and analysis were not pre-registered.

    “This paper’s design and analysis were not pre-registered.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Study design and conductown data

    Quality control was performed to ensure participants were not responding randomly in the ITC and RA tasks by verifying that responses were a function of task variables, and data from participants with a Tjur coefficient below 0.20 were discarded.

    “We performed quality control to ensure that participants were not responding randomly in the ITC and RA tasks by verifying that their responses were a function of task variables that should be relevant to the choice (as in Pehlivanova et al., 2018).”
    • Also stated in: § Neurocognitive evaluation · plain
      “We assessed the goodness-of-fit of these regression models using the coefficient of discrimination (Tjur, 2009) and discarded data from participants who had a Tjur coefficient value < 0.20.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Pehlivanova et al., 2018

      Not checked in the free run.

    • cites Tjur, 2009

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    To ensure uniformity in data collection, tasks were piloted with two volunteers at each site in their respective languages, and screenshots and videos of the tasks were checked during these pilot sessions to standardize stimuli presentation.

    “Subsequently, to ensure uniformity in data collection, the tasks were piloted with two volunteers at each site in their respective languages. To guarantee the standardization of stimuli presentation across sites, screenshots and videos of the tasks were checked during these pilot sessions.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    The STAN study found comparable task performance between India and USA sites, indicating cross-national reliability of the STAN for that sample.

    “The performance across tasks was comparable between the two sites, indicating cross-national reliability of the STAN, at least with respect to this sample.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Cherkil et al., 2012

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The study's sample of 221 participants across five sites provides at least 80% power to detect a partial eta-squared of 0.0523 or greater at alpha .05, so it has adequate power for at least medium effect sizes.

    “The sample size of 221 participants across 5 sites provides at least 80% power to detect differences with a partial eta squared of 0.0523 or greater at the .05 level. Hence, we have adequate power to detect at least medium effect sizes.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Examiners at all sites were required to familiarize themselves with the SOP and the tasks to ensure uniform examiner training.

    “Examiners at all sites were required to familiarize themselves with the SOP and the tasks to ensure uniformity in the training of the examiners.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Study design and conductnone given

    A standard operating procedures (SOP) manual was created as a reference guide for all sites to ensure uniformity in task administration.

    “A manual of standard operating procedures (SOP) was created to serve as a reference guide for all sites to ensure uniformity in task administration.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    In the CNTB study, significant differences between ethnic groups were found for most tests, mainly explained by educational attainment, which accounted for 15% of the total variance.

    “Significant differences between ethnic groups were found for most tests, mainly attributable to differences in educational attainment, explaining 15% of the total variance.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nielsen et al., 2018

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Prospective data harmonization may help researchers combine individual participant data from various sites more effectively in the era of replication studies.

    “In the era of replication studies, prospective data harmonization may help researchers combine individual participant data from various sites more effectively (Griffith et al., 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Griffith et al., 2013

      Not checked in the free run.

  • May combine two claims.

    Premisereasoning

    Both the STAN and CNTB studies highlight the effect of language and educational attainment on neurocognitive performance.

    “Both studies highlight the effect of language and educational attainment on neurocognitive performance.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    During the COVID-19 pandemic, some testing conditions were modified for safety, but the core procedures remained the same.

    “During the COVID-19 pandemic, some modifications to the testing conditions were made to ensure all safety protocols were followed, but the core procedures remained the same.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Cognitive performance, especially fluid intelligence, is expected to decrease with age.

    “cognitive performance, especially skills related to fluid intelligence, is expected to decrease with age (Cattell, 1963; Baltes et al., 1999)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Cattell, 1963

      Not checked in the free run.

    • cites Baltes et al., 1999

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    In models testing site and sociodemographic effects, each sociodemographic association was controlled for the remaining sociodemographic variables.

    “Importantly, these models testing sites and sociodemographic variables were mutually controlled (i.e., the association with age was controlled by sex, years of education, and SES; the association with sex was controlled by age, years of education, and SES, and so on).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous studies found better ToL performance by males, including on higher difficulty items.

    “These findings are similar to those of previous studies that found better performance by males, including on items with higher difficulty levels (Sousa et al., 2001; Mataix-Cols & Bartrés-Faz, 2002).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Sousa et al., 2001

      Not checked in the free run.

    • cites Mataix-Cols & Bartrés-Faz, 2002

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Some cross-national studies have shown differential memory performance in Western versus Eastern samples, driven by differential focus on salient objects versus context.

    “Although some cross-national studies have shown differential memory performance in Western (Americans, Canadians, or Western Europeans) versus Eastern (Chinese, Japanese, or Koreans) samples, driven by a differential focus on salient objects vs. context (Park and Huang 2010; Leger and Gutchess 2021)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Park and Huang 2010

      Not checked in the free run.

    • cites Leger and Gutchess 2021

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Evaluators at all sites completed online ethics training and were certified.

    “Evaluators from all sites completed online training on ethics in research and were certified after completing this course.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    Fluid intelligence is known to correlate with planning ability.

    “As fluid intelligence is known to correlate with planning ability (D’Antuano et al. 2016)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites D’Antuano et al. 2016

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    The analyses did not correct for multiple comparisons and used an alpha level of 0.05 to maximize sensitivity to site differences.

    “Given that we wanted our analyses to be as sensitive as possible to site differences, we opted not to correct for multiple comparisons; therefore, the alpha level adopted in this study was 0.05.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Written informed consent was obtained from all study participants.

    “Also, written informed consent was obtained from all study participants.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    More difficult N-back levels exert greater load on working memory and produce more errors.

    “with more difficult levels exerting greater load on working memory, and more errors.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Numerous previous studies find humans tend to slow with age in processing speed and motor reactions.

    “Numerous previous studies that have examined processing speed and motor reactions over the lifespan find that humans tend to slow with age (Salthouse, 1996, Nilsson et al., 2014; Papp et al., 2014).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Salthouse, 1996

      Not checked in the free run.

    • cites Nilsson et al., 2014

      Not checked in the free run.

    • cites Papp et al., 2014

      Not checked in the free run.

  • May combine two claims.

    Interpretationnone given

    This is the first study to use multiple prospectively harmonized neurocognitive tasks to examine cognition across these five countries, and the first to do so in strictly evaluated healthy samples from Brazil, India, the Netherlands, South Africa and the USA.

    “To our knowledge, this is the first study of its kind to use multiple prospectively harmonized neurocognitive tasks to examine similarities and differences in cognition across these five countries, distributed on different continents.”
    • Also stated in: § CONCLUSION · hedged
      “To our knowledge, this is the first study to harmonize these five neurocognitive tasks across sites and is certainly the first to do so in samples of healthy participants strictly evaluated (in terms of psychiatric symptoms) from Brazil, India, the Netherlands, South Africa, and the USA.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Study design and conductown data

    The age range of 18-50 and recruitment restricted to participants with IQ>80 and no current or past psychiatric disorder preclude generalizing the findings to older adults or to participants with borderline IQ.

    “the age range of study participants (18–50) and the fact that we only recruited participants with IQ>80 without a current or past history of psychiatric disorders precludes us from generalizing our findings to older adults or participants with borderline IQ.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Study design and conductreasoning

    Because the task sequence was not counterbalanced, fatigue or other order effects could have affected the results and hampered generalization of the findings.

    “all participants conducted the evaluation by performing the tasks in the same order: since we did not counterbalance the tasks sequence, it is possible that fatigue or other order effects in our sample could affect the results hampering the generalization of our findings.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A tendency toward risk aversion has been previously reported among Indian participants, particularly in rural, low-resource settings.

    “A tendency toward risk aversion has been previously reported among Indian participants, particularly in rural, low-resource settings (e.g., Binswanger, 1980; Senapati, 2020)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Binswanger, 1980

      Not checked in the free run.

    • cites Senapati, 2020

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous studies evaluating ToL performance across the lifespan in predominantly Western populations noted performance remains stable from late adolescence through the fourth decade of life.

    “although previous studies evaluating ToL performance across the lifespan in predominantly Western populations (Kaller et al., 2016; Unterrainer et al., 2019) have noted that performance remains stable from late adolescence through the fourth decade of life.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Kaller et al., 2016

      Not checked in the free run.

    • cites Unterrainer et al., 2019

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Even with identical instructions and standardization, cross-site differences in results could arise from external factors such as sample selection, intelligence, motivation, attention, evaluator expertise, or random factors.

    “Even if we could have the exact same instructions and standardization of the tasks in different sites, different results could arrive from other external factors, like sample selection, different levels of intelligence, motivation or attention during the test, evaluators’ expertise, or other random factors related to the evaluation.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. May combine two claims.

    Premisereasoning

    Harmonizing task instructions, administration procedures and testing environment aims to give participants at all sites similar testing conditions and equivalent understanding of the instructions.

    “The rationale behind the harmonization of the task instructions, administration procedures, and testing environment is to ensure that participants at all sites have similar testing conditions and have received and understood the task instructions the same way.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    The study's results associating SES with ToL performance confirm and add to existing literature that has identified an association between SES and cognitive performance.

    “Finally, our results associating SES with ToL performance also confirm and add to the existing literature that has previously identified an association between SES and cognitive performance (Wu et al., 2016; Gonzalez et al., 2020; Taylor et al., 2021).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Wu et al., 2016

      Not checked in the free run.

    • cites Gonzalez et al., 2020

      Not checked in the free run.

    • cites Taylor et al., 2021

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Lack of generalized trust in the social environment may lead to higher discounting rates.

    “Lack of generalized trust in the social environment may lead to higher discounting rates (Jachimowicz et al., 2017).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Jachimowicz et al., 2017

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The site differences in exclusion proportions do not represent a lack of task harmonization but likely reflect other subject-specific factors that differ between sites.

    “Given the strict procedural standards and quality control cutoffs across sites, these differences do not represent a lack of task harmonization but instead the likely presence of other subject-specific factors that differ between sites.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Not correcting for multiple comparisons increases the chance of false positives, that is, of concluding a variable differs across sites when it does not.

    “in order to increase sensitivity for finding differences across sites, we opt not to use any method for correcting for multiple comparisons. This increases the chances of finding false positives, i.e., to consider that a specific variable is different across sites when, in reality, it is not.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Cultural influences may still play a role in interpreting task performance across sites, through task familiarity, patterns of abilities, commitment to the evaluation, and cultural values.

    “Nevertheless, cultural influences may still play a role in terms of task familiarity, patterns of abilities, commitment to the evaluation, and cultural values, in interpreting task performance across sites.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Premisereasoning

    Ensuring that tasks measure a meaningful latent construct equivalently across groups (measurement invariance) is a crucial aspect of cross-national cognitive research, beyond comparing means and standard deviations.

    “A crucial aspect for the field of cross-national investigations in cognitive measures, beyond the average and standard deviation comparison, is to ensure that the tasks have a meaningful latent construct that is being measured equivalently across all groups (measurement invariance).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    The cross-site results suggest the Indian risk-aversion tendency may not be related to SES, since SES was controlled and no demographic effects were observed for RA measures.

    “but our cross-site results suggest that this tendency may not be related to SES, once this covariate was controlled in the analysis and no demographic effects were observed to relate with the RA measures.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    One important factor influencing delay discounting is trust that delayed outcomes will materialize; uncertainty about delayed rewards can make immediate payoffs preferable.

    “One important factor that influences delay discounting is trust that delayed outcomes will materialize; when there is uncertainty about whether or when delayed rewards will arrive, it can be preferable to take immediate payoffs instead (McGuire & Kable, 2013; Kidd et al., 2013).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites McGuire & Kable, 2013

      Not checked in the free run.

    • cites Kidd et al., 2013

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Stereotype threat alters neurocognitive performance.

    “the stereotype threat has been indicated to alter neurocognitive performance (Moritz et al., 2018)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Moritz et al., 2018

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The SSRT showed no site effects or variability differences, which may indicate consistency across countries in inhibition response.

    “The fact that we did not observe site effects in the SSRT, nor in its variability, may indicate consistency across countries in this task that evaluates the inhibition response.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Interpretationnone given

    It is difficult to guarantee that measured covariates are reliable and reflect the same construct across sites.

    “even measuring possible confounding variables that could play a role in cognitive performance, it is remarkably difficult to guarantee that those covariates are reliable and reflect the same construct across sites.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    Years of education is not a direct measure of academic achievement, because repeating years of school is not captured and a measure of time does not evaluate schooling quality.

    “the sociodemographic variable “years of education” is not a direct measure of academic achievement, as a participant could have repeated years of school and only a measure of time does not evaluate the quality of schooling.”
    Quote in the paperNot a substantial claim
95 of 95
  • The paper relies on this without support.

    The neurocognitive tasks measure the same cognitive constructs across all five sites despite translation and cultural differences.

    “All sites used the same version of the tasks. Task instructions, originally in English and Dutch, were translated into Afrikaans, Dutch, English, Kannada, and Brazilian Portuguese for administering with participants proficient in these languages.”
  • The paper relies on this without support.

    The different IQ tests used across sites are valid and comparable for excluding participants with IQ below 80.

    “IQ < 80, assessed with different, but validated, tests across the sites”
  • The paper relies on this without support.

    The neurocognitive tasks measure the same cognitive constructs comparably across the five sites and languages, so between-site differences reflect cognitive differences rather than measurement artifacts.

    “Employing prospective harmonization methods, we assessed healthy individuals from five countries on a standard, computerized neurocognitive test battery administered in individuals’ native language or individuals who were proficient in the task language.”
    “Our expectation was that through prospective harmonization we would minimize process measurement error”
  • The paper relies on this without support.

    The WAMI is a valid and comparable measure of socioeconomic status across all five sites.

    “adjusted for the covariates of sex, age, education, and SES (as measured by the WAMI)”
  • The paper relies on this without support.

    The quality control exclusion criteria correctly identify unusable task data without introducing site-dependent bias.

    “the percentage of derived task scores that were deemed to be outside quality control limits, including participant non-completion, were summarized for each task and compared using Fisher’s exact test across sites”
  • The paper relies on this without support.

    The pre/post March 20, 2020 comparison isolates effects of COVID protocols from other temporal or site differences.

    “we compared task performance between participants tested before (n = 131) and after (n = 90) March 20th, 2020, when we started using specific protocols to evaluate participants during the COVID-19 pandemic.”
  • The paper relies on this without support.

    The sample of healthy adults is comparable across sites after adjusting for sociodemographic covariates.

    “by controlling for sociodemographic covariates we would minimize sample selection differences between sites.”
  • The paper relies on this without support.

    The tasks' difficulty levels are comparable across sites.

    “A random intercept and slope general linear mixed model was used to test differences and associations across difficulty levels (“difficulty slope”) for the N-Back and ToL tasks.”
  • The paper relies on this without support.

    The five neurocognitive tasks measure the same latent constructs equivalently across the five sites (measurement invariance holds), so that cross-site comparisons of task scores are meaningful.

    “Future studies with larger samples are recommended to better understand how each of the five tests used here behaves in different countries and whether there is measurement invariance across the sites.”
9 of 9

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The choice set used to measure discount rates was widely adopted and designed to capture a broad range of discount rates.

    “We used a widely adopted choice set designed to capture a broad range of discount rates31–37.”

    From Temporal discounting predicts procrastination in the real world (2024) · cites this paper as [37]

    The Methods (Neurocognitive evaluation; page not available) describe a 51-choice intertemporal task used to estimate discount rates, with delayed rewards spanning 1–180 days. Our copy does not say the choice set was widely adopted or designed to capture a broad range of discount rates; a range of delays is not the same claim. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • RA effect after dropping India is not below the stated small-effect cutoff

    Minor

    The abstract characterizes the remaining site effects as partial eta-squared < 0.05 after dropping India for RA. The RA results report 0.05 and 0.06, neither of which is below 0.05; the paper's own rule of thumb calls 0.06 a medium effect.

  • Abstract omits the USA exception for ToL

    Minor

    The abstract says the Netherlands performed more accurately on ToL than the other sites, with an exception only for N-back. The ToL results say its total accuracy was higher than three sites, but not the USA.

  • Other RA sites are said both to differ and not differ

    Minor

    The discussion says the non-India sites did not differ from each other on risk aversion. The results explicitly report greater risk aversion in Brazil than in the Netherlands for both RA measures.

  • Limitations deny past psychiatric diagnoses present in the sample

    Minor

    The limitations describe participants as having no current or past psychiatric disorders. The results report participants with past diagnoses of MDD and anxiety disorders.

  • Abstract exempts the USA from the N-back difference

    Minor

    The abstract says the Netherlands' higher N-back accuracy did not extend to a comparison with the USA. The results report significantly higher accuracy in the Netherlands than in the USA (87% versus 84%, p = 0.031).

5 of 5

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. Griffith L, van den Heuvel E, Fortier I, Hofer S, Raina P, Sohel N, Payette H, Wolfson C, & Belleville S. (2013). Harmonization of Cognitive Measures in Individual Participant Data and Aggregate Data Meta-Analysis. Agency for Healthcare Research and Quality (US). https://pubmed.ncbi.nlm.nih.gov/23617017/ 23617017
  2. Mazur J. (1987). An adjusting procedure for studying delayed reinforcement. in Quantitative Analyses of Behavior: Vol. 5: The Effect of Delay and of Intervening Events on Reinforcement Value (eds. Commons ML, Mazur JE & Nevin JA) 55– 73 (Erlbaum, 1987).
  3. Richardson JTE (2011). Eta squared and partial eta squared as measurements of effect size in educational research. Educational Research Review, 6, 135– 147.

Cited by

Sorted by citations

Authors
Batistuzzo, M. C., Sheshachala, K., Alschuler, D. M., Hezel, D. M., Lewis-Fernández, R., de Joode, N. T., Vriend, C., Lempert, K. M., Narayan, M., Marincowitz, C., Lochner, C., Stein, D. J., Narayanaswamy, J. C., van den Heuvel, O. A., Simpson, H. B., & Wall, M.
Affiliations
  • Universidade de São Paulo (BR)
  • National Institute of Mental Health and Neurosciences (IN)
  • New York State Psychiatric Institute (US)
  • Amsterdam Neuroscience (NL)
  • University of Pennsylvania (US)
  • South African Medical Research Council (ZA)
Venue
Neuropsychology
Published
2023-03
Volume
37
Issue
3
Pages
284-300
ISSN
  • 0894-4105 (ISSN-L)
  • 1931-1559
OpenAlex
W4283816302
Cited by
4
References
62
Citations by year
2026: 1 · 2024: 3
FWCI
0.69
Type
journal article
Language
en
Open access
Locations
  • Neuropsychology (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Pure Amsterdam UMC (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
National Institute of Mental Health (R01 MH113250)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords
neuropsychological assessment, Tower of London, stop-signal task, risk aversion, intertemporal choice, cognitive performance, socioeconomic status, unmeasured confounding, sex differences, age differences
MeSH terms
Educational Status, Humans, Longitudinal Studies, Neuropsychological Tests, Prospective Studies, Social Class

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

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