CogScreen testing

I found all the literature on this practice was based on a comment that mentions the possibility of infection prevention in a very old scientific article that then was quoted without criteria. The quote was then quoted over generations of scientific papers without evaluation of the original statement. The practice became the standard without any evidence that the practice prevented newborn infection.

CogScreen-AE (Aviation Edition) is an example of a standard practice that needs to be revisited. CogScreen is used by the FAA Civil Aviation Medical Institute, which evaluates class one, two, and three pilot medicals, as a yes/no criteria for granting a medical for pilots who have had drug or alcohol problems and/or are on antidepressants. This annual requirement is controversial at best. The test is used for pilots who have had a brain injury as well. (The FAA just dropped the annual requirement for antidepressant use—a small step forward since the practice has no basis in science.)

Dr. Jack Hastings, a brilliant neurologist and aerospace specialist who died in 2021, was adamant against using CogScreen in this way. He was right, and it is time the FAA stopped using CogScreen in such an absolute way. CogScreen use needs to be limited or eliminated.

CogScreen was developed in the late 1980s and owned by Dr. Gary Kay. There are a few articles in refereed medical publications and many papers presented at scientific meetings. Most of these articles and papers list Kay as the lead or contributing author, which may affect objectivity. The last scientific article listed on the CogScreen site was in 2000, ancient history in the world of medicine. That article tested 100 pilots using an early Frasca 141 flight simulator. The study states, “The results support the validity of CogScreen-AE, illustrate the non-uniformity of age-related differences in cognitive and motor performance, and point to some areas of assessment that warrant further development.” I am not sure what that means, but it’s hardly an unfettered endorsement.

The test favors younger pilots who have grown up with computer games and is prejudiced against older pilots who have not.I became a CogScreen administrator working with Kay many years ago. The test is a computer-based, interactive test that supposedly measures cognitive and motor functions that relate to flying. However, the test is based on norms by testing pilots and developing a bell curve. The CogScreen norms have not been developed on pilots who are tested in a modern simulator, rated on that testing, and then tested with CogScreen and scores correlated.

There is no evaluation of the validity of doing CogScreen annually when there is a certain amount of test learning that can affect results of any computer testing (I have one pilot who has taken the test annually for more than 25 years!). After giving the tests to several pilots, I believed the testing was not doing what it was supposed to be doing and stopped, taking the loss on the specialized screen and computer I was required to buy.

The test favors younger pilots who have grown up with computer games and is prejudiced against older pilots who have not. The test may evaluate reaction times but does not assess judgment, which may keep an older pilot from needing the reaction times of the youth.

CogScreen is an easy path for the FAA, but since the pilots who are required to take this expensive test are also evaluated by an FAA-approved neuropsychologist, neurologist, and psychiatrist, why is the computer test required and why should it have such an absolute impact on granting a pilot’s medical, sometimes overriding the opinions of the professionals?

The FAA has become comfortable using CogScreen over the past 30 years. Just like performing caesarean sections for herpes, the practice of using a test because it has been done for so long needs to be reevaluated.

In my opinion, the use of CogScreen needs to be stopped or validated using objective and modern criteria.

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