Cognitive Screening (TRIACOG) for adults with cerebrovascular diseases: Construction process and validity evidence.

Abstract

This study presents the construction process of the Cognitive Screening Instrument (TRIACOG) for evaluating poststroke adults. The TRIACOG has undergone a rigorous developmental process: (a) literature review; (b) analysis of the most sensitive items on a brief neuropsychological evaluation to differentiate between clinical and healthy cases; (c) addition of items; (d) content analysis by expert judges; (e) reformulation of the instrument; (f) pilot study; (g) reformulation of the instrument; (h) a second pilot study in a clinical sample; and (i) analysis of evidence of criterion validity. The TRIACOG evaluates 8 functions: orientation, verbal and visual episodic-semantic memory, praxis, attention/working memory, executive functions, language, and numerical processing. The TRIACOG provides evidence of content and criterion validity. This article may guide the construction of items of other neuropsychological instruments. It is hoped that the TRIACOG may contribute to studies and neuropsychological clinical trials that evaluate poststroke patients.

Validity evidence for the Cognitive Screening Test in Stroke Patients

“…Control participants were members of the general community and were recruited following the same steps as those employed by Rodrigues et al (2020) in the construction and investigation of validity evidence for the TRIACOG. Illiterate individuals, those with poor performance in the Mini Mental State Examination -MMSE (using a cut-off point adjusted for education: 22 points for individuals with up to 7 years of formal education and 23 points for those with 8 to 11 years of formal education; Kochhann et al, 2010), and those who scored above 9 points on the BDI-II screening test for depressive symptoms (Gorenstein et al, 2011) were excluded from the control group.…”

“…In a previous study, interpretations of the TRI-ACOG showed validity evidence and significant performance differences in all tasks between post-stroke patients and healthy individuals. Patients' performance was worse compared to a group of healthy individuals, with effect sizes ranging from medium to large for most tasks (Rodrigues, Salles, & Bandeira, 2020). That study controlled for the effects of age and education on participants' performance in comparative analyses of performance differences between poststroke patients and the control group (Rodrigues, Salles, & Bandeira, 2020).…”

“…The Cognitive Screening Test was developed to fill this gap (TRIACOG; . The TRIACOG was constructed based on theoretical models in which neuropsychological functions rely on a broad and integrated network of interrelated cognitive functions (Rodrigues, Bandeira, & Salles, 2020). The instrument comprises tasks that measure multiple cognitive functions impacted by stroke.…”

“…The instrument comprises tasks that measure multiple cognitive functions impacted by stroke. It also includes tasks to assess subprocesses of cognitive domains such as language and executive functions, which are seldom measured by the most commonly administered tests (i.e., MMSE and MoCA; Rodrigues, Bandeira & Salles, 2020).…”

“…Considering the influence of age and education in post-stroke cognitive outcome (Bento-Torres et al, 2017;Pinto et al, 2018), the current study aims to obtain further validity evidence for the TRIACOG, expanding the sample studied by Rodrigues, Salles, and Bandeira (2020) and analyzing the effect of external variables on test results. This was done by assessing main effects and interactions between the variables group type (clinical/ control), age (groups of individuals between 40-59 and 60-75 years of age), and education (3-7 and 8-11 years of formal study).…”