The Childhood Cancer Survivor Study–Neurocognitive Questionnaire (CCSS-NCQ) Revised: Item response analysis and concurrent validity.

Abstract

Objective Childhood cancer survivors are at risk for neurocognitive impairment related to cancer diagnosis or treatment. This study refined and further validated the Childhood Cancer Survivor Study Neurocognitive Questionnaire (CCSS-NCQ), a scale developed to screen for impairment in long-term survivors of childhood cancer. Method Items related to task efficiency, memory, organization and emotional regulation domains were examined using item response theory (IRT). Data were collected from 833 adult survivors of childhood cancer in the St. Jude Lifetime Cohort Study who completed self-report and direct neurocognitive testing. The revision process included: 1) content validity mapping of items to domains, 2) constructing a revised CCSS-NCQ, 3) selecting items within specific domains using IRT, and 4) evaluating concordance between the revised CCSS-NCQ and direct neurocognitive assessment. Results Using content and measurement properties, 32 items were retained (8 items in 4 domains). Items captured low to middle levels of neurocognitive concerns. The latent domain scores demonstrated poor convergent/divergent validity with the direct assessments. Adjusted effect sizes (Cohen's d) for agreement between self-reported memory and direct memory assessment were moderate for total recall (ES=0.66), long-term memory (ES=0.63), and short-term memory (ES=0.55). Effect sizes between self-rated task efficiency and direct assessment of attention were moderate for focused attention (ES=0.70) and attention span (ES=0.50), but small for sustained attention (ES=0.36). Cranial radiation therapy and female gender were associated with lower self-reported neurocognitive function. Conclusion The revised CCSS-NCQ demonstrates adequate measurement properties for assessing day-to-day neurocognitive concerns in childhood cancer survivors, and adds useful information to direct assessment.

Risk of late effects of treatment in children newly diagnosed with standard-risk acute lymphoblastic leukaemia: a report from the Childhood Cancer Survivor Study cohort

“…This threshold was used in the original development of the CCSS neurocognitive questionnaire, 18 has been used in numerous subsequent publications, 6 (further reading list in appendix) and has been demonstrated to be a valid threshold comparison to direct testing using traditional neuropsychological assessment in a large cohort of adult survivors of childhood cancer. 19 …”

Racial and ethnic disparities in neurocognitive, emotional, and quality‐of‐life outcomes in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

“…21 It contains 4 subscales, including task efficiency, emotional regulation, organization, and memory, derived from a 25-item questionnaire. 21 It contains 4 subscales, including task efficiency, emotional regulation, organization, and memory, derived from a 25-item questionnaire.…”

Stroke impact on mortality and psychologic morbidity within the Childhood Cancer Survivor Study

“…The CCSS-Neurocognitive Questionnaire (NCQ) is a 25-item questionnaire that assessed 4 neurocognitive domains: 1) task efficiency; 2) emotional regulation; 3) organization; and 4) memory. 17 Domain scores for each participant Cancer March 1, 2020 are calculated using a 3-point Likert scale with a range of 1 ("never a problem") to 3 ("often a problem"). These scores were compared with normative data to generate T scores, with participants with scores ≥63 classified as impaired.…”