Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, FL 33136, USA.
Am J Psychiatry. 2011 Nov;168(11):1195-201. doi: 10.1176/appi.ajp.2011.10121723. Epub 2011 May 15.
Treatment of cognitive impairment has been proposed as an intervention to reduce disability in people with schizophrenia. The Validation of Everyday Real-World Outcomes (VALERO) study was conducted to evaluate functional rating scales and to identify the rating scale or scales most robustly related to performance-based measures of cognition and everyday living skills.
Adults with schizophrenia (N=198) were tested with the neurocognitive measures from the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery, the UCSD Performance-Based Skills Assessment-Brief Version, and the advanced finances subscale of the Everyday Functioning Battery. They and an informant (a friend, relative, clinician, or case manager) also reported their everyday functioning on six rating scales. Best judgment ratings were generated by an interviewer who administered the rating scales to patients and informants.
Statistical analyses developed an ability latent trait that reflected scores on the three performance-based (i.e., ability) measures, and canonical correlation analysis related interviewer ratings to the latent trait. The overall fit of the model with all six rating scales was good. Individual rating scales that did not improve the fit of the model were systematically deleted, and a final model with two rating scales was fitted to the data. A regression analysis found that the Specific Levels of Functioning Assessment was a superior predictor of the three performance-based ability measures.
Systematic assessments of real-world functioning were related to performance on neurocognitive and functional capacity measures. Of the six rating scales evaluated in this study, the Specific Levels of Functioning Assessment was the best. Use of a single rating scale provides an efficient assessment of real-world functioning that accounts for considerable variance in performance-based scores.
有人提出认知障碍治疗可作为减少精神分裂症患者残疾的一种干预措施。Validation of Everyday Real-World Outcomes（VALERO）研究旨在评估功能评定量表，并确定与认知和日常生活技能表现测试关联性最强的评定量表。
198 名成年精神分裂症患者接受了神经认知测试，包括来自 Measurement and Treatment Research to Improve Cognition in Schizophrenia（MATRICS）共识认知测试电池的认知测试、UCSD Performance-Based Skills Assessment-Brief Version 以及 Everyday Functioning Battery 的高级财务子量表。患者及其知情人（朋友、亲属、临床医生或个案管理员）还对他们的日常功能进行了六种评定量表的报告。最佳判断评分由一位对患者和知情人进行评分量表测试的访谈者生成。
统计分析开发了一个能力潜在特征，该特征反映了三种基于表现的（即能力）测试的分数，而典型相关分析则将访谈者评分与潜在特征联系起来。包含六种评分量表的模型整体拟合度良好。系统删除那些未改善模型拟合度的个别评分量表，并拟合数据得到最终的两个评分量表模型。回归分析发现，特定水平的功能评估是三个基于表现的能力测试的更好预测指标。
对现实世界功能的系统评估与神经认知和功能能力测试的表现相关。在本研究中评估的六种评分量表中，特定水平的功能评估是最好的。使用单一评分量表可对现实世界功能进行高效评估，能很好地解释基于表现的评分中的大量差异。
