The Cognitive Status Scale: A Preliminary Investigation of Psychometric Properties in a Clinically Referred Pediatric Critical Care Sample.

IF 3.1 3区医学 Q2 CLINICAL NEUROLOGY

Neurocritical Care Pub Date : 2025-05-16 DOI:10.1007/s12028-025-02281-6

Trevor A Hall, Susanne W Duvall, Lauren Demers, Natalia Rich-Wimmer, Cydni N Williams

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引用次数: 0

Abstract

Background: Cognitive morbidities persist after pediatric critical care. However, a significant gap exists related to measuring cognitive outcomes in this patient population due to heterogeneity in presentations and objective measures. This study's purpose was to develop a psychometrically sound coding system to summarize clinically generated and performance-based neuropsychological outcomes to be used for research.

Methods: The work was conducted in two stages: (1) Cognitive Status Scale (CSS) development and (2) a retrospective pilot test in a clinically referred sample of post-critical-care youth aged 6-19 years (N = 110) to explore preliminary psychometric properties of the CSS.

Results: Principal components analysis supported the CSS structure (capturing 59% of the total explained variance). Internal consistency (α = 0.82) and interrater reliability (r = 0.92) were good. Within the full sample, criterion-related validity was demonstrated as the CSS total composite score from long-term evaluation and was significantly correlated with abbreviated performance-based cognitive outcomes from the acute recovery phase (Neurocognitive Index, r = 0.74). Divergent validity was shown via significant differences on the CSS total composite score between known clinical groups (≥ 3 Functional Status Scale [FFS] change = 30.23 vs. ≤ 2 FFS change = 50.94, t = 4.10, p ≤ 0.001, d = 0.91) and across CSS clinical indicators (F_3,106 = 8.4495, p = < 0.001, η² = 0.194). Bivariate correlations showed a significant association in the expected direction between the CSS total composite score and the Functional Status Scale total score (r = - 0.44, p ≤ 0.001), as well as a significant association in the expected direction between the CSS total composite score and the Behavior Rating Inventory of Executive Function, Second Edition General Executive Composite (r = - 0.29, p = 0.010).

Conclusions: Primary evidence shows the CSS to be a reliable and valid measure for summarizing a clinically administered battery of cognitive assessments. Easy-to-generate metrics of performance-based cognition are essential to progress the state of the science germane to cognitive outcomes post pediatric critical care.

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认知状态量表：临床转诊儿科危重护理样本心理测量特性的初步调查。

背景：儿童重症监护后认知疾病持续存在。然而，由于表现和客观测量的异质性，在测量该患者群体的认知结果方面存在显著差距。本研究的目的是开发一个心理计量学上健全的编码系统，以总结临床产生的和基于表现的神经心理学结果，用于研究。方法：分两个阶段进行：(1)认知状态量表（CSS）的编制；(2)对临床参考的6-19岁重症监护后青年（N = 110）进行回顾性先导测试，初步探讨CSS的心理测量学特征。结果：主成分分析支持CSS结构（占总解释方差的59%）。内部一致性（α = 0.82）和间信度（r = 0.92）较好。在整个样本中，标准相关的效度被证明为长期评估的CSS总复合评分，并且与急性恢复期基于表现的简短认知结果显著相关（神经认知指数，r = 0.74）。已知临床组间（≥3次功能状态量表[FFS]变化= 30.23，≤2次功能状态量表变化= 50.94,t = 4.10, p≤0.001,d = 0.91）和不同临床指标间（f3106 = 8.4495, p = 2 = 0.194）的差异均显示出差异效度。双变量相关性显示，CSS综合总分与功能状态量表总分在预期方向上显著相关（r = - 0.44, p≤0.001），CSS综合总分与执行功能行为评定量表第二版通用执行综合量表在预期方向上显著相关（r = - 0.29, p = 0.010）。结论：初步证据表明，CSS是一种可靠和有效的方法来总结临床应用的一系列认知评估。易于生成的基于性能的认知指标对于儿科危重症后认知结果相关的科学进展至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurocritical Care 医学-临床神经学

CiteScore

7.40

自引率

8.60%

发文量

221

审稿时长

4-8 weeks

期刊介绍： Neurocritical Care is a peer reviewed scientific publication whose major goal is to disseminate new knowledge on all aspects of acute neurological care. It is directed towards neurosurgeons, neuro-intensivists, neurologists, anesthesiologists, emergency physicians, and critical care nurses treating patients with urgent neurologic disorders. These are conditions that may potentially evolve rapidly and could need immediate medical or surgical intervention. Neurocritical Care provides a comprehensive overview of current developments in intensive care neurology, neurosurgery and neuroanesthesia and includes information about new therapeutic avenues and technological innovations. Neurocritical Care is the official journal of the Neurocritical Care Society.