Simão Sara, Naumann Lucas L, de Carvalho Mamede, Santos Miguel Oliveira, Martins Isabel Pavão
Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Avenida Professor Egas Moniz, Lisbon 1649-028, Portugal.
Centro de Estudos Egas Moniz, Faculty of Medicine, University of Lisbon, Avenida Professor Egas Moniz, Lisbon 1649-028, Portugal.
Arch Clin Neuropsychol. 2025 Apr 27;40(3):553-564. doi: 10.1093/arclin/acae118.
This study aims to adapt and provide psychometric support for the validation of version B of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) for the Portuguese population, addressing the need for consistent cognitive evaluations in amyotrophic lateral sclerosis (ALS). A second culturally adapted ECAS screen facilitates the accurate characterization of ALS progression, mitigates learning effects, and supports tailored care management.
The adaptation process included forward-backward translation, cultural adaptation, and cognitive debriefing on a prospective sample of 193 ALS patients and 106 controls. A multiple regression analysis identified predictors relevant for establishing ECAS cut-off scores. Psychometric evaluations, including reliability assessments and tests of convergent, construct, and criterion validity, were conducted. Additionally, version A's psychometric properties were reevaluated with complementary analyses and a larger sample.
Version B demonstrated good internal consistency with Cronbach's alpha of 0.802, comparable to the previously established version A. Moderate inter-item correlations further supported reliability, reflecting internal coherence. Equivalence testing between the Portuguese versions supported convergent validity, confirming version B's alignment with version A's theoretical framework. Exploratory factor analysis provided preliminary support for construct validity, and receiver operating characteristic analyses established cut-off values for both versions, revealing moderate sensitivity with a tendency toward false negatives, and higher specificity.
This study provided evidence for the cultural suitability, reliability, and validity of the Portuguese ECAS B. As evidence supports the equivalence of the Portuguese ECAS versions, they can be used for flexible screenings and applied with the calculated cut-off values to enhance diagnostic accuracy.
本研究旨在对爱丁堡认知与行为性肌萎缩侧索硬化症筛查量表（ECAS）B版进行改编，并为其在葡萄牙人群中的验证提供心理测量学支持，以满足肌萎缩侧索硬化症（ALS）患者进行一致认知评估的需求。第二个经过文化改编的ECAS筛查量表有助于准确描述ALS的进展情况，减轻学习效应，并支持个性化的护理管理。
改编过程包括正反翻译、文化适应，以及对193例ALS患者和106例对照的前瞻性样本进行认知汇报。多元回归分析确定了与建立ECAS临界值相关的预测因素。进行了心理测量学评估，包括可靠性评估以及收敛效度、结构效度和效标效度测试。此外，还通过补充分析和更大的样本对A版的心理测量学特性进行了重新评估。
B版表现出良好的内部一致性，Cronbach's α系数为0.802，与先前建立的A版相当。适中的项目间相关性进一步支持了可靠性，反映了内部一致性。葡萄牙语版本之间的等效性测试支持了收敛效度，证实了B版与A版理论框架的一致性。探索性因素分析为结构效度提供了初步支持，受试者工作特征分析确定了两个版本的临界值，显示出中等敏感性且有假阴性倾向，以及较高的特异性。
本研究为葡萄牙语ECAS B版的文化适宜性、可靠性和有效性提供了证据。由于证据支持葡萄牙语ECAS版本的等效性，它们可用于灵活筛查，并应用计算出的临界值以提高诊断准确性。
