Nuechterlein Keith H, Green Michael F, Kern Robert S, Baade Lyle E, Barch Deanna M, Cohen Jonathan D, Essock Susan, Fenton Wayne S, Frese Frederick J, Gold James M, Goldberg Terry, Heaton Robert K, Keefe Richard S E, Kraemer Helena, Mesholam-Gately Raquelle, Seidman Larry J, Stover Ellen, Weinberger Daniel R, Young Alexander S, Zalcman Steven, Marder Stephen R
Department of Psychology, UCLA Semel Institute for Neuroscience and Human Behavior, 300 Medical Plaza, Rm. 2251, Los Angeles, CA 90095-6968, USA.
Am J Psychiatry. 2008 Feb;165(2):203-13. doi: 10.1176/appi.ajp.2007.07010042. Epub 2008 Jan 2.
The lack of an accepted standard for measuring cognitive change in schizophrenia has been a major obstacle to regulatory approval of cognition-enhancing treatments. A primary mandate of the National Institute of Mental Health's Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative was to develop a consensus cognitive battery for clinical trials of cognition-enhancing treatments for schizophrenia through a broadly based scientific evaluation of measures.
The MATRICS Neurocognition Committee evaluated more than 90 tests in seven cognitive domains to identify the 36 most promising measures. A separate expert panel evaluated the degree to which each test met specific selection criteria. Twenty tests were selected as a beta battery. The beta battery was administered to 176 individuals with schizophrenia and readministered to 167 of them 4 weeks later so that the 20 tests could be compared directly.
The expert panel ratings are presented for the initially selected 36 tests. For the beta battery tests, data on test-retest reliability, practice effects, relationships to functional status, practicality, and tolerability are presented. Based on these data, 10 tests were selected to represent seven cognitive domains in the MATRICS Consensus Cognitive Battery.
The structured consensus method was a feasible and fair mechanism for choosing candidate tests, and direct comparison of beta battery tests in a common sample allowed selection of a final consensus battery. The MATRICS Consensus Cognitive Battery is expected to be the standard tool for assessing cognitive change in clinical trials of cognition-enhancing drugs for schizophrenia. It may also aid evaluation of cognitive remediation strategies.
缺乏用于衡量精神分裂症认知变化的公认标准,一直是认知增强治疗获得监管批准的主要障碍。美国国立精神卫生研究所的精神分裂症认知改善测量与治疗研究(MATRICS)计划的一项主要任务是,通过对测量方法进行广泛的科学评估,开发一种用于精神分裂症认知增强治疗临床试验的共识认知成套测验。
MATRICS神经认知委员会评估了七个认知领域中的90多项测试,以确定36项最有前景的测量方法。一个独立的专家小组评估了每项测试符合特定选择标准的程度。选择了20项测试作为试用成套测验。对176名精神分裂症患者进行了试用成套测验,并在4周后对其中167人进行了重新测试,以便直接比较这20项测试。
给出了最初选择的36项测试的专家小组评分。对于试用成套测验,给出了重测信度、练习效应、与功能状态的关系、实用性和耐受性的数据。基于这些数据,选择了10项测试来代表MATRICS共识认知成套测验中的七个认知领域。
结构化的共识方法是选择候选测试的可行且公平的机制,在一个共同样本中对试用成套测验进行直接比较,从而能够选择最终的共识成套测验。MATRICS共识认知成套测验有望成为精神分裂症认知增强药物临床试验中评估认知变化的标准工具。它也可能有助于评估认知康复策略。