Sherer Mark, Nick Todd G, Millis Scott R, Novack Thomas A
Neuropsychology Department, Methodist Rehabilitation Center, Jackson, MS 39216, USA.
J Clin Exp Neuropsychol. 2003 Jun;25(4):512-20. doi: 10.1076/jcen.25.4.512.13877.
The Wisconsin Card Sorting Test (WCST) has been found to be valid in characterizing cognitive dysfunction in a variety of neurological disorders including traumatic brain injury (TBI). However, the test has been criticized as being too lengthy and frustrating for severely impaired patients. As a result, shortened versions of the WCST have been proposed. The utility of one of these shortened versions, the Wisconsin Card Sorting Test-64 (WCST-64), was examined in 106 persons with TBI. Findings showed strong associations between scores derived from the two tests. WCST scores were predicted from WCST-64 scores with sufficient accuracy for research purposes with adjusted R-squared values ranging from .74 to .87. Using the standard cutpoint of < 40T to indicate impairment or normal performance for perseverative responses from each of the two tests, 91 (86%) of 106 subjects received the same classification showing substantial agreement (Kappa statistic 0.71; 95% CI 0.58-0.84). The WCST and the WCST-64 also performed comparably in predicting functional status at discharge from inpatient rehabilitation using the first score from a principal components analysis as a summary measure (both significant with p = .0002). These findings support theuse of the WCST-64 in early evaluations of persons with moderate and severe TBI.
威斯康星卡片分类测验（WCST）已被证明在表征包括创伤性脑损伤（TBI）在内的多种神经系统疾病的认知功能障碍方面是有效的。然而，该测试因对严重受损患者来说过于冗长且令人沮丧而受到批评。因此，有人提出了WCST的缩短版本。在106名TBI患者中对其中一个缩短版本——威斯康星卡片分类测验64项（WCST - 64）的效用进行了检验。结果显示，两种测试得出的分数之间存在很强的关联。从WCST - 64分数预测WCST分数的准确性足以用于研究目的，调整后的决定系数值在0.74至0.87之间。使用<40T的标准切点来表明两种测试中持续性反应的损伤或正常表现，106名受试者中有91名（86%）得到了相同的分类，显示出高度一致性（卡方统计量0.71；95%置信区间0.58 - 0.84）。使用主成分分析的第一个分数作为汇总指标，WCST和WCST - 64在预测住院康复出院时的功能状态方面也表现相当（两者均显著，p = 0.0002）。这些发现支持在对中度和重度TBI患者的早期评估中使用WCST - 64。
