Department of Neurosurgery, Elisabeth-TweeSteden Hospital, 5022 GC Tilburg, The Netherlands.
Department of Cognitive Neuropsychology, Tilburg University, 5037 AB Tilburg, The Netherlands.
J Int Neuropsychol Soc. 2020 Feb;26(2):187-196. doi: 10.1017/S1355617719001164. Epub 2019 Nov 8.
This study aimed to examine: (1) patient-proxy agreement on executive functioning (EF) of patients with primary brain tumors, (2) the relationships between patient- and proxy-report with performance-based measures of EF, and (3) the potential influence of performance-based measures on the level of agreement.
Meningioma and low-grade glioma patients and their informal caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF-A) 3 months after surgery. The two index scores of the BRIEF-A, Behavioral Regulation and Metacognition, were evaluated. Mean scores of patients and proxies were compared with normative values and with each other. Patient-proxy agreement was evaluated with Lin's concordance correlation coefficients (CCCs) and Bland-Altman plots. Pearson correlation coefficients between reported EF and performance-based measures of EF were calculated. Multiple regression analysis was used to evaluate the potential influence of test performance on differences in dyadic reports.
A total of 47 dyads were included. Patients reported significantly more problems on the Metacognition Index compared to norms, and also in comparison with their proxies. Effect sizes indicated small differences. Moderate to substantial agreement was observed between patients and proxies, with CCCs of 0.57 and 0.61 for Metacognition and Behavioral Regulation, respectively. Correlations between reported EF and test performance ranged between -0.37 and 0.10. Dyadic agreement was not significantly influenced by test performance.
Patient-proxy agreement was found to be moderate. No clear associations were found between reported EF and test performance. Future studies should further explore the existing and new methods to assess everyday EF in brain tumor patients.
本研究旨在检验：（1）原发性脑肿瘤患者的患者-代理人在执行功能（EF）方面的一致性，（2）患者和代理人报告与基于表现的 EF 测量之间的关系，以及（3）基于表现的测量对一致性水平的潜在影响。
脑膜瘤和低级别胶质瘤患者及其非专业照护者在手术后 3 个月完成行为评定量表的执行功能（BRIEF-A）。评估 BRIEF-A 的两个指标评分，即行为调节和元认知。比较患者和代理人的平均得分与常模和彼此之间的得分。采用林氏一致性相关系数（CCCs）和 Bland-Altman 图评估患者-代理人的一致性。计算报告的 EF 与基于表现的 EF 测量之间的 Pearson 相关系数。采用多元回归分析评估测试表现对二元报告差异的潜在影响。
共纳入 47 对患者和代理人。与常模相比，患者在元认知指数上报告的问题明显更多，与代理人的报告相比也更多。效应量表明存在较小的差异。患者和代理人之间观察到中度至高度的一致性，元认知和行为调节的 CCC 分别为 0.57 和 0.61。报告的 EF 与测试表现之间的相关性在-0.37 到 0.10 之间。二元一致性不受测试表现的显著影响。
发现患者-代理人的一致性为中度。报告的 EF 与测试表现之间没有明显的关联。未来的研究应进一步探索评估脑肿瘤患者日常 EF 的现有和新方法。
