CHU de Québec-Université Laval Research Centre, Québec City, QC, Canada.
Montreal University Hospital Center (CHUM) Research Centre, Montreal, QC, Canada.
BMC Cancer. 2023 Jan 9;23(1):35. doi: 10.1186/s12885-022-10470-1.
Cancer-related cognitive impairment (CRCI) is one of the most concerning conditions experienced by patients living with cancer and has a major impact on their quality of life. Available cognitive assessment tools are too time consuming for day-to-day clinical setting assessments. Importantly, although shorter, screening tools such as the Montreal Cognitive Assessment or the Mini-Mental State Evaluation have demonstrated a ceiling effect in persons with cancer, and thus fail to detect subtle cognitive changes expected in patients with CRCI. This study addresses this lack of cognitive screening tools by developing a novel tool, the Fast Cognitive Evaluation (FaCE).A population of 245 patients with 11 types of cancer at different illness and treatment time-points was enrolled for the analysis. FaCE was developed using Rasch Measurement Theory, a model that establishes the conditions for a measurement tool to be considered a rating scale.FaCE shows excellent psychometric properties. The population size was large enough to test the set of items (item-reliability-index=0.96). Person-reliability (0.65) and person-separation (1.37) indexes indicate excellent internal consistency. FaCE's scale is accurate (reliable) with high discriminant ability between cognitive levels. Within the average testing time of five minutes, FaCE assesses the main cognitive domains affected in CRCI.FaCE is a rapid, reliable, and sensitive tool for detecting even minimal cognitive changes over time. This can contribute to early and appropriate interventions for better quality of life in patients with CRCI. In addition, FaCE could be used as a measurement tool in research exploring cognitive disorders in cancer survivors.
癌症相关认知障碍（CRCI）是癌症患者最关注的状况之一，对其生活质量有重大影响。现有的认知评估工具在日常临床评估中耗时过长。重要的是，尽管较短，但筛查工具，如蒙特利尔认知评估或简易精神状态评估，在癌症患者中表现出上限效应，因此无法检测到 CRCI 患者预期的微妙认知变化。本研究通过开发一种新工具——快速认知评估（FaCE）来解决这种认知筛查工具的缺乏。
一项针对不同疾病和治疗时间点的 11 种癌症的 245 名患者的人群被纳入分析。FaCE 的开发使用了 Rasch 测量理论，该理论建立了一个测量工具被视为评分量表的条件。FaCE 具有出色的心理测量特性。人群规模足够大，可以测试一组项目（项目可靠性指数=0.96）。个人可靠性（0.65）和个人分离（1.37）指数表明具有出色的内部一致性。FaCE 的量表在评估 CRCI 中受影响的主要认知领域方面是准确的（可靠的），具有高区分能力。在平均五分钟的测试时间内，FaCE 评估了随时间推移的认知变化。这有助于对 CRCI 患者进行早期和适当的干预，以提高其生活质量。此外，FaCE 可作为研究癌症幸存者认知障碍的测量工具。
