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[公式:见正文]儿童脑肿瘤的可靠变化:初步研究。

[Formula: see text] Reliable change in pediatric brain tumor: A preliminary investigation.

机构信息

Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.

Department of Psychology, University of Calgary, Calgary, AB, Canada.

出版信息

Child Neuropsychol. 2020 Jan;26(1):15-26. doi: 10.1080/09297049.2019.1620715. Epub 2019 Jun 4.

Abstract

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.

摘要

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。

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