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"Background: This position paper highlights the opportunistic integral role of the pharmacist across the patient pathway utilizing cardiovascular care as an example. The paper aims to highlight the potential roles that pharmacists worldwide can have (or already have) to provide efficient patient care in the context of interprofessional collaboration. Methods: It results from a literature review and experts seeking advice to identify existing interventions and potential innovative interventions. We developed a conceptual framework highlighting seven critical phases in the patient pathway and for each of those listed some of the initiatives identified by our experts worldwide. Results: Existing pharmacists' interventions in each of these phases have been identified globally. Various examples in the area of prevention and self‐management were found to exist for long; the contribution for early detection and subsequently to timely diagnosis were also quite clear; integration of care was perhaps one of the areas needing greater development, although interventions in secondary care were also quite common. Tertiary care and end of life interventions were found to often be left for other healthcare professionals. Conclusion: On the basis of the findings, we can argue that much has been done but globally consider that pharmacists are still an untapped resource potentially useful for improved patient care." info:eu-repo/semantics/publishedVersion

The neuromodulatory subcortical system (NSS) nuclei are critical hubs for survival, hedonic tone, and homeostasis. Tau-associated NSS degeneration occurs early in Alzheimer's disease (AD) pathogenesis, long before the emergence of pathognomonic memory dysfunction and cortical lesions. Accumulating evidence supports the role of NSS dysfunction and degeneration in the behavioral and neuropsychiatric manifestations featured early in AD. Experimental studies even suggest that AD-associated NSS degeneration drives brain neuroinflammatory status and contributes to disease progression, including the exacerbation of cortical lesions. Given the important pathophysiologic and etiologic roles that involve the NSS in early AD stages, there is an urgent need to expand our understanding of the mechanisms underlying NSS vulnerability and more precisely detail the clinical progression of NSS changes in AD. Here, the NSS Professional Interest Area of the International Society to Advance Alzheimer's Research and Treatment highlights knowledge gaps about NSS within AD and provides recommendations for priorities specific to clinical research, biomarker development, modeling, and intervention. HIGHLIGHTS: Neuromodulatory nuclei degenerate in early Alzheimer's disease pathological stages. Alzheimer's pathophysiology is exacerbated by neuromodulatory nuclei degeneration. Neuromodulatory nuclei degeneration drives neuropsychiatric symptoms in dementia. Biomarkers of neuromodulatory integrity would be value-creating for dementia care. Neuromodulatory nuclei present strategic prospects for disease-modifying therapies.

There have been ongoing debates as to how, or even whether, we should clinically classify gender diversity in children through clinical classification manuals. So-called 'depathologizing' is argued as being vital to address the stigma that these children are somehow disordered or sick. Yet one argument in favour of continued clinical classification for transgender and gender non-conforming children is that it better facilitates access to specialist psychological support. I argue that whilst continued clinical classification offers a seemingly pragmatic solution to ensuring access, it does in fact obscure our understanding of the individual needs of these children. In this paper I address fundamental issues that aim to better our understanding of need and thus why a child may benefit from specialist support. I do so by critiquing a paper I nearly wrote, which argued for the ongoing continued classification of gender incongruence in children. Ultimately, I argue that specialist psychological support and care should be driven by the needs of the individual child, as determined by the child and those involved with their care. By bettering our understanding as to why specialist psychological support may be beneficial for some, we move past the focus of such specialist support being provided because of the child's gender diversity. Methodologically the paper may be unusual, in comparison to traditional normative counter-argumentative bioethical position papers, but by presenting an argument for depathologization of gender diversity of children in this way there is also an alternative insight into the methods of bioethics.

Background Global Doctors for Choice—a transnational network of physician advocates for reproductive health and rights—began exploring the phenomenon of conscience-based refusal of reproductive healthcare as a result of increasing reports of harms worldwide. The present White Paper examines the prevalence and impact of such refusal and reviews policy efforts to balance individual conscience, autonomy in reproductive decision making, safeguards for health, and professional medical integrity. Objectives and search strategy The White Paper draws on medical, public health, legal, ethical, and social science literature published between 1998 and 2013 in English, French, German, Italian, Portuguese, and Spanish. Estimates of prevalence are difficult to obtain, as there is no consensus about criteria for refuser status and no standardized definition of the practice, and the studies have sampling and other methodologic limitations. The White Paper reviews these data and offers logical frameworks to represent the possible health and health system consequences of conscience-based refusal to provide abortion; assisted reproductive technologies; contraception; treatment in cases of maternal health risk and inevitable pregnancy loss; and prenatal diagnosis. It concludes by categorizing legal, regulatory, and other policy responses to the practice. Conclusions Empirical evidence is essential for varied political actors as they respond with policies or regulations to the competing concerns at stake. Further research and training in diverse geopolitical settings are required. With dual commitments toward their own conscience and their obligations to patients’ health and rights, providers and professional medical/public health societies must lead attempts to respond to conscience-based refusal and to safeguard reproductive health, medical integrity, and women's lives.

Internet voting is currently used in binding elections in 10 countries, and is being considered in many others. In almost all instances where it has been implemented, it is offered as a complementary method of voting; often with the aim to make voting easier and thereby improve turnout. In many municipalities in Canada, however, the adoption of online voting has meant the simultaneous elimination of paper ballots. Drawing on data from a large survey of paper and Internet voters in the 2014 municipal elections in the province of Ontario, Canada, this article examines the effects of eliminating paper ballots on electors based on their digital literacy. We show that digital access and literacy are strongly related to voting method when paper ballots are an option. When paper ballots are unavailable, however, the voting population is made up of more technologically savvy electors, though this effect is delayed and does not occur in the first election without paper ballots. We interpret this finding to indicate that the elimination of paper ballots can disenfranchise those on the wrong side of the digital divide.

OBJECTIVES In this paper, we provide an overview of best practices in FASD prevention, diagnostic, and interventions and supports. In Canada, people diagnosed with Fetal Alcohol Spectrum Disorder (FASD) represent a fraction people living with FASD. While social stigma may deter people from seeking an FASD diagnosis, other deterrents include the lack of screening and diagnostic referrals, cost of travelling to a clinic, and lack of clarity of how a diagnosis may improve supports and services. Preventing FASD and improving lifelong outcomes for people living with FASD requires a coordinated approach between prevention, diagnostic, intervention, and support efforts. METHODS Using the example of Newfoundland and Labrador, a province where 60% of the population lives in rural communities and benefits from being involved in national initiatives and partnerships, we discuss efforts underway in other Canadian provinces to address FASD. RESULTS We make three recommendations that begin to address FASD-specific needs in both rural and urban regions: a) a provincial FASD consultant position, b) an explicit partnership between provincial government and fasdNL, and c) increased access to FASD diagnostic teams. CONCLUSION While the recommendations are both modest and essential first steps, we also suggest that collaborations and resource-sharing in FASD prevention and supports are more about doing things differently, rather than doing more.

J Clin Hypertens (Greenwich). 2010;12:757‐764. © 2010 Wiley Periodicals, Inc. Nonadherence and poor or no persistence in taking antihypertensive medications results in uncontrolled high blood pressure, poor clinical outcomes, and preventable health care costs. Factors associated with nonadherence are multilevel and relate not only to the patient, but also to the provider, health care system, health care organization, and community. National guideline committees have called for more aggressive approaches to implement strategies known to improve adherence and technologies known to enable changes at the systems level, including improved communication among providers and patients. Improvements in adherence and persistence are likely to be achieved by supporting patient self‐management, a team approach to patient care, technology‐supported office practice systems, better methods to measure adherence, and less clinical inertia. Integrating high blood pressure control into health care policies that emphasize and improve prevention and management of chronic illness remains a challenge. Four strategies are proposed: focusing on clinical outcomes; empowering informed, activated patients; developing prepared proactive practice teams; and advocating for health care policy reform. With hypertension remaining the most common reason for office visits, the time is now.

The medical specialty of physical medicine and rehabilitation (PMR) has had a proven impact on persons with disability and on health care systems. Documents such as The White Book on Physical and Rehabilitation Medicine in Europe have been important in defining the scope of practice within various regions. However, on some continents, the practice has not been well defined.To explore the practice of PMR in subSaharan Africa and Antarctica.Medline searches, membership data searches, fax survey of medical schools, Internet searches, and interviews with experts.The continents are dissimilar in terms of climate and government. However both Antarctica and subSaharan Africa have no PMR training programs, no professional organizations, no specialty board requirements, and no practicing physicians in the field. Because there are no known disabled children on Antarctica and adults are airlifted to world-class health care, the consequences of this deficit are minimal there. However, the 788,000,000 permanent residents of subSaharan Africa, including approximately 78 million persons with disability, are left unserved.Antarctica is doing fine. Africa is in a crisis. Local medical schools, hospitals doctors, and persons with disability; along with foreign volunteers, aid groups, and policymakers can impact the crisis. However government-specifically national ministries of health-is ultimately responsible for the health and wellbeing of citizens.

Purpose It has been estimated that medication errors (ME) are responsible for 7000 deaths each year. Some studies show that electronic prescribing systems have achieved health benefits and patient safety, resulting in a saving of resources. Other studies suggest that they may increase adverse events. Objective The objective of this study was to compare medication errors between electronic and paper-based prescription detected during pharmacovigilance. Methods This was an observational, cross-sectional comparative study of 600 randomized medical records that were systematically reviewed by a pharmacovigilance team, with a deliberate search for ME. Each error was classified according to its severity, National Coordinating Council for Medication Error and Prevention taxonomy and high-risk medications. The number of errors was calculated per 100 prescribed medications, number of errors per record and number of records with an error as a quality indicator. Results A total of 229 ME were found with a mean per record of 0.38 (SD = 0.7), of which 155 corresponded to the paper-based method (1.04, SD = 1.67) and 74 to the electronic-based method (0.29, SD = 0.57) P =

Rationale, aims and objectives Despite extensive evidence on the value of patient decision support interventions (DESIs), there is no consensus on optimal DESI formats. Assessing clinicians' perceptions about DESI formats can help facilitate their adoption. The aim of this study was to assess clinicians' perceptions of DESIs formats and potential use in practice. Methods Semi-structured qualitative interviews were conducted with doctors from diverse practice areas (internal medicine, OB/GYN, surgery, medical oncology, emergency medicine) and elicited perceptions toward patient DESIs formats (digital vs. paper) and timing of administration. Questions also elicited beliefs underlying attitudes, perceived social norms and self-efficacy for using DESIs and the feasibility of doing so. Data analysis was conducted using a thematic analysis approach. Results Participants identified strengths of both more comprehensive digital and shorter paper-based tools and thought they could complement each other. Participants consistently expressed the advantages of using DESIs outside the consultation to supplement clinical discussions about cancer decisions given the amount of information to discuss during these emotion-laden conversations. Participants felt that patients with older age and lower socio-economic status were more likely to use a paper-based compared with a digital DESI. Participants also noted challenges related to reliable resources such as computers and Internet in the practice setting, which would be necessary for implementing the digital DESIs on site. Conclusions Clinicians' perceptions and opinions about value of DESIs can vary widely across doctor, patient and clinic characteristics. A one-size-fits-all approach to implementation might not be feasible, suggesting that flexible approaches to providing decision support for patients are needed to drive broader adoption.

Significant contributions have been made since the World Health Organization published Brian Abel-Smith's pioneering comparative study of national health expenditures more than 50 years ago. There have been major advances in theories, model specifications, methodological approaches, and data structures. This introductory essay provides a historical context for this line of work, highlights four newly published studies that move health economics research forward, and indicates several important areas of challenging but potentially fruitful research to strengthen future contributions to the literature and make empirical findings more useful for evaluating health policy decisions. Copyright © 2016 John Wiley & Sons, Ltd.

The World Health Organization (WHO) recently commissioned a report reviewing evidence on electronic cigarettes and making policy recommendations. A version of it was subsequently published as an academic paper. We identify important errors in the description and interpretation of the studies reviewed, and find many of its key conclusions misleading.

This issue of the journal contains a very insightful and informative paper by Bryan Dowd. Although health services research is a relatively new field, there are valuable lessons to be learned from an historical review of critical junctures involving its core methodological disciplines, including statistics, economics, and sociology. Extensive use of observational data and need for causally defensible results makes health services research an ideal stage for comparing disciplines. This commentary begins by addressing some of the major points in Dowd (2011, this issue) followed by a review of how causality has featured in my own work. The commentary concludes by describing causality from the operational subjective statistics viewpoint, which complements Dowd's paper because it has a different philosophical foundation than the frequentist and Bayesian paradigms and a different viewpoint of causality.

This summary paper for the symposium provides a brief overview of the papers by Craig Veitch, John Beard and Max Kamien that deal with the environmental, socioeconomic and political descriptors of 'rurality'. Those three papers deal with a number of fundamental truths about rural and remote health, including the fact that internal migration is an important and poorly understood factor in determining community and health outcomes. A brief treatment of the issue suggests that selective internal migration is likely to mean that the burden of illness in rural and remote areas is even higher than that suggested by the published figures. The paper then asserts that thinking in the rural and remote health sector in Australia focuses largely on the negative aspects of the current characteristics of rural areas. A self-evident definition of 'rurality' is offered that has it defined by the set of factors that currently characterise places, communities and individuals outside the major cities. The paper suggests that each of these characteristics has an upside or benefit, as well as a downside or risk, and that giving greater attention to the former will provide a better basis for informing rural health policy and practice than the deficit view alone.

Rationale, aims and objectives The objective of this study was to apply a paper-based clinical reminder to improve the adherence to lipid guidelines. Methods Patients with coronary heart disease (CHD) without lipid-lowering therapy (LLT) were recruited, and medical records were reviewed. Eligible subjects were randomized; a clinical reminder stating current standards and local insurance policy was stamped on the paper chart in the study group but not in the control. The primary outcome was new LLT subscription in the 6-month follow-up period, and the secondary end point was the composite result of LLT or lipid profile check-up. Results Ninety-two patients were assigned to the study group and 102 to the control group. The primary outcome showed no difference at the end of 6 months (OR: 1.70, P = 0.248, 95% CI: 0.69–4.19). The secondary end point was significantly higher in the reminder group (OR: 2.81, P = 0.001, 95% CI: 1.57–5.04). Conclusion A paper chart based clinical reminder providing update clinical recommendations could modify the doctor's behaviour and improve the attention to lipid levels. However, its effect cannot be transformed into an increase in LLT or a decrease in low-density lipoprotein level owing to local policy constraint.

Because of the many advantages, computerized questionnaires are used more often in youth surveys, replacing the more traditional paper-and-pencil (pp Bowling 2005), it is important to determine whether responses to computerized questionnaires are comparable to those obtained by paper-and-pencil method. So far, findings from previous studies among school-aged children and adolescents are inconclusive. Several studies did not find major differences between computerized and paper-and-pencil questionnaires (Truman et al. 2003; Hays and McCallum 2005; Mangunkusumo et al. 2005, 2006; McCabe et al. 2005), whereas other studies showed that adolescents disclose more sensitive information in computerized questionnaires than in paper-and-pencil conditions (Paperny et al. 1990; Turner et al. 1998; Wright, Aquilino, and Supple 1998; Wang et al. 2005) or found (gender-related) differences for some topics (Beebe et al. 1998; Webb et al. 1999; Hallfors et al. 2000; Vereecken and Maes 2006). Of these studies, a few were web-based (Mangunkusumo et al. 2005, 2006; McCabe et al. 2005; Wang et al. 2005). Several factors may be responsible for the differences found in these studies. It is known that the validity of self-reports may be affected by cognitive as well as situational factors. Factors considered especially influential include the presence of others while responding to questions and the respondents’ perceptions of privacy or confidentiality (Brener, Billy, and Grady 2003; Bowling 2005). A perceived lack of privacy or confidentiality could cause response bias because of a fear of reprisal. In particular, behavior that is illegal, stigmatized, or laden with moral implications may be underreported because of this concern (Brener et al. 2003). As the setting of computerized administration of questionnaires at schools is likely to be different from the administration of paper-and-pencil questionnaires, it is important to investigate respondents’ perceived level of privacy and confidentiality as a possible source of response bias. However, little is known about adolescents’ perceived level of privacy and confidentiality in surveys. Because of this and the inconsistent pattern that appears from the literature, the following issues were examined in the present study: (a) (gender-related) differences in perceived level of privacy and confidentiality between web-based and paper-and-pencil questionnaires and (b) (gender-related) differences in the report of indicators of (mental) health and behavior between web-based and paper-and-pencil questionnaires when taking into account pupils’ perceived level of privacy and confidentiality.

Health Services Research (HSR) is pleased to announce a new feature called “The Theme Series.” The journal will from to time issue a call for papers on a specific “theme” considered to be of particular significance to the field and importance for current health care policy. Manuscripts submitted for the Theme Issue will undergo the usual HSR peer review process. Articles that meet HSR's high standards for publication will be further evaluated for relevance and significance, and the best 8–10 articles will be gathered into an issue devoted entirely to the announced theme. Accepted manuscripts that are not selected for the Theme Issue will be automatically accepted for publication in a regular issue. The first theme selected is “Improving Efficiency and Value in Health Care” in which we seek to publish research that will help improve the value and efficiency of the American Healthcare System. This Theme Issue is sponsored by the Agency for Healthcare Research and Quality (AHRQ), which will assist HSR in publicizing the call and disseminating the findings of the selected studies. (See the Call for Papers at http://www.hsr.org.) This theme is particularly fitting to initiate this new feature because it presents a conundrum for researchers and policy makers alike. HSR aims to attract the best research on this theme in time to contribute to the national debate and collective interest about health care that attends election years. We all recognize that high and rising healthcare costs—especially when accompanied by gaps in quality, safety, equity, and access—are unsustainable. Federal and state policy makers, along with private payers and systems leaders, are seeking new ways to reduce waste, increase efficiency of health care delivery, and allocate resources in order to improve value in health care. Consumers also seek guidance about how to maximize the value of their own health care dollar, particularly as some payer innovations have increased consumers' financial exposure. We invite you to respond to our call with your research to add value and efficiency to our system. The processes used for Theme Issues in the new Theme Series will differ from those HSR uses for its regular and special issues in several ways. Manuscripts submitted for regular issues, of course, are unsolicited. The Co-Editors-in-Chief (EIC) make an initial judgment of the suitability of each submitted manuscript for our audience and the quality of the work. Manuscripts surviving this cut are then assigned to one of the eight Senior Associate Editors (SAE) for additional review before deciding to send it out for external peer review (see Luft and Flood 2003; Flood 2004; Luft 2004 for more details). The most appropriate SAE is chosen for each manuscript based on the topic of the research and the SAE's experience and academic discipline. Special issues, on the other hand, are of two basic types (see Luft 2003 for details). Most special issues consist of a series of papers presented at a conference. A few special issues have resulted from a special call for papers. In both cases, however, the special issues are proposed and sponsored by organizations or groups external to HSR that approach the Journal with a particular topic in mind. A guest editor from the organization or group proposing the topic, working with an assigned SAE, plays a role in reviewing and selecting articles for publication based on their suitability for the special issue. In contrast, for the Theme Series, the editors and publisher of HSR will select the themes and subsequently seek sponsorship for publishing and disseminating the resulting issue. HSR will then issue a targeted call for papers. Papers submitted to HSR in response to the call will first undergo the process for regular manuscripts, i.e., the EICs will make the initial cut based on fit and quality and then assign remaining manuscripts to the most appropriate SAE for another internal review and decision to send for external peer review. Subsequently, as with regular manuscripts, SAEs will make a recommendation to the EIC on acceptance, revision, or rejection. All manuscripts accepted through this process will be scheduled for electronic publication in Online Early; these articles are fully published and may be cited. It usually takes a few weeks from the date the accepted manuscript and required forms are received by our Managing Editor until they are published online. It is during the “final” step—scheduling for print publication—that the Theme Issue manuscripts will be handled differently. At this point, one SAE (and Guest Editor, if any) will be assigned to review all accepted manuscripts responding to our call, taking into account both external reviewer and SAE assessments of manuscripts' originality and significance as well as their fit to the theme. The SAE and Guest Editor will select specific papers to be published in the Theme Issue, and recommend them to the EICs, who will make the final decisions on selection. Accepted manuscripts that are not selected for the Theme Issue will be published in regular issues. Why would authors be interested in submitting their best work for publication in a Theme Issue? There are several important advantages from an author's perspective: First, and most important, extra attention is likely to be focused on the manuscripts that are printed in the Theme Issue for several reasons. Theme Issues are more likely to draw attention to the topic and therefore to the manuscripts in the issue, which will also feature an editorial on the importance and timeliness of the theme and the contributions made by each manuscript. The Theme Issue is likely to get additional attention from the planned extra dissemination that will accompany publication of Theme Issues. Second, there is potential for speeding up the review cycle since we will be monitoring the process for these manuscripts more closely in order to keep them on track for the intended publication date. Third, once manuscripts are accepted, they will be published promptly in Online Early. Moreover, selection for the Theme Issue is likely to result in “jumping the queue” for print publication in HSR since the Theme Issue is likely to come to print earlier than regular manuscripts accepted at the same point in time. Finally, we plan to introduce another new electronic feature related to the Theme Issue to allow readers to comment on the papers and themes. What are the potential benefits for HSR? While we remain strongly committed to our principal mission to publish high quality, original and significant research in the field of health services research, we also want to help build the field and bolster its ability to make an impact in changing the health care system through building the underlying science and evidence base. High-quality Theme Issues will offer a visible and effective mechanism for accomplishing these goals. With these aims in mind, we have also initiated: The From the Editors series, where the editors analyze HSR with the goal of making our intent and objectives and the process of publishing more transparent (see http://www.hsr.org). We have (with permission) provided an example of peer review at http://www.hsr.org using a real manuscript at HSR going through the documents as initially submitted to receiving reviews and letters from us to responding to reviewers until finally being accepted. We initiated a new policy in 2007 to make more transparent to readers of each manuscript the authors' potential conflicts of interests, the sponsor's roles in the conduct of research and publishing the work, and authorship and contributorship based on explicit definitions of these terms; these disclosures now be a published part of each article at HSR (Luft, Flood, and Escarce 2006). In collaboration with AcademyHealth, we publish the President's address and selected Roundtable discussions featuring translations of research to policy and clinical settings from the Annual Research Meetings. In honor of John M. Eisenberg, we initiated an annual award for the best article published in HSR that addresses one of Dr. Eisenberg's principal areas of research or leadership (Flood and Luft 2004) see current and past recipients at http://www.hsr.org. We feature occasional manuscripts, which we call “Building the Field,” that are designed to improve the training and development of the field of health services research (see HSR 42(1, part I) for two examples). We invite you to help us in this latest new feature by contributing your best work to the Theme Series as we all seek to add value to the field and to our health care system.

Background Appreciating the need to better translate biomedical research into improved clinical care and health, the NIH Roadmap was initiated in 2003 to focus on this by strengthening NIH’s central role in clinical research and clinical research training. As part of the needed re-engineering, in 2006 NIH began the CTSA program. At this writing (Summer 2009), there are 39 CTSAs at leading universities across the United States, each having a clinical research graduate program and extensive resources for promoting clinical and translational research. Each of these, and the CTSA Consortium as a whole, are committed to transforming clinical and translational research to maximize impact on health. The CTSAs bring to this challenge an array of capacities, extensive research infrastructure, formal training and career development programs, community engagement of the public and of clinical practice communities, and informatics related to research and clinical practice. Various CTSAs have different areas of emphasis, including along the spectrum of translational research from bench to patient bedside (the first translational step, “T1”), from the bedside to general use in clinical practice (“T2”), and from clinical practice to public benefit and policy (“T3”). This broad array of activities has allowed the national consortium to be responsive to needs all along this path of translation of biomedical research into practice and public benefit. Although the activities of CER can be seen as primarily involving T2 and T3 research, they also can be seen as focusing on the optimal translation of T1 research into effective treatment, and thus the very epitome of work in which CTSAs should be deeply involved. This appreciation was reinforced by CER’s selection as a key Strategic Goal focus of the CTSA Consortium. In this context, the CER Strategic Goal of the CTSA Consortium is to promote the translation of the results of clinical and translational research into practice and public policy. In service of this, in two sections below, we review the span of CER resources across the CTSA Consortium and propose potential roles for CTSAs in supporting CER. As a point of reference for this White Paper, below are two important definitions of CER from reports released at the end of June 2009, from the IOM and from the FCC-CER: Definition from the IOM Report on Priorities for CER The generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. The purpose of CER is to assist patients, clinicians, purchasers, and policy makers, and the public to make informed decisions that will improve healthcare at both the individual and population levels.

Background Existing tools for rapid cognitive assessment in HIV-positive individuals with mild cognitive deficits lack sensitivity or do not meet psychometric requirements for tracking changes in cognitive ability over time. Methods Seventy-five nondemented HIV-positive patients were evaluated with the Montreal Cognitive Assessment (MoCA), a brief battery of standardized neuropsychological tests, and computerized tasks evaluating frontal-executive function and processing speed. Rasch analyses were applied to the MoCA data set and subsequently to the full set of data from all tests. Results The MoCA was found to adequately measure cognitive ability as a single, global construct in this HIV-positive cohort, although it showed poorer precision for measuring patients of higher ability. Combining the additional tests with the MoCA resulted in a battery with better psychometric properties that also better targeted the range of abilities in this cohort. Conclusion This application of modern test development techniques shows a path towards a quick, quantitative, global approach to cognitive assessment with promise both for initial detection and for longitudinal follow-up of cognitive impairment in patients with HIV infection.