Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
Department of Psychology, University of Calgary, Calgary, AB, Canada.
Child Neuropsychol. 2020 Jan;26(1):15-26. doi: 10.1080/09297049.2019.1620715. Epub 2019 Jun 4.
Children treated for brain tumor show evidence of declines in general intellectual abilities (i.e., IQ). Group-level data indicate subtle declines over time on average, but no study has utilized a clinical criterion to identify and describe a reliable change in survivors of pediatric brain tumor (PBT). In this study, we discuss the utility of reliable change index (RCI) methodology to supplement group-level analysis (e.g., repeated measures ANOVA). This pilot sample consisted of 22 children ( age = 10.47 years) treated for PBT who completed initial and follow-up assessments ( interval = 23.58 months). Cognitive data included composite scores from the WISC-IV. An RCI -score was calculated for each participant on each composite score based on two different test-retest reliability coefficients. As a group, survivors of PBT did not demonstrate a statistically significant change from initial to follow-up on any WISC-IV composite score. When RCI was calculated based on reliability coefficients with shorter test-retest intervals provided by the test publisher, 77% of survivors demonstrated a reliable change in performance on at least one measure. The frequency of RCI decreases in working memory was significantly higher than expected. In contrast, only 32% of survivors showed reliable changes on at least one measure when RCI was based on a reliability coefficient derived from a clinical sample with a longer retest interval. This study demonstrates that highly divergent results may be obtained with RCI and the importance of the source of reliability estimates.
接受脑瘤治疗的儿童表现出一般智力能力(即智商)下降的证据。群体水平的数据表明,平均而言,随着时间的推移会出现细微的下降,但没有研究利用临床标准来识别和描述儿科脑肿瘤(PBT)幸存者的可靠变化。在这项研究中,我们讨论了可靠变化指数(RCI)方法的实用性,以补充群体水平分析(例如,重复测量方差分析)。该试点样本由 22 名接受 PBT 治疗的儿童组成(年龄=10.47 岁),他们完成了初始和随访评估(间隔=23.58 个月)。认知数据包括 WISC-IV 的综合分数。根据两种不同的测试-重测信度系数,为每个参与者的每个综合分数计算了一个 RCI 分数。作为一个群体,PBT 幸存者在任何 WISC-IV 综合分数上都没有表现出从初始到随访的统计学显著变化。当 RCI 基于测试出版商提供的较短测试-重测间隔的可靠性系数计算时,77%的幸存者在至少一项测量中表现出可靠的变化。工作记忆中 RCI 的频率下降显著高于预期。相比之下,当 RCI 基于具有较长重测间隔的临床样本得出的可靠性系数时,只有 32%的幸存者在至少一项测量中表现出可靠变化。本研究表明,RCI 可能会产生截然不同的结果,并且可靠性估计的来源非常重要。