Validation and clinical utility of the executive function performance test in persons with traumatic brain injury

Abstract

This study examined the relationships between the Executive Function Performance Test (EFPT), the NIH Toolbox Cognitive Function tests, and neuropsychological executive function measures in 182 persons with traumatic brain injury (TBI) and 46 controls to evaluate construct, discriminant, and predictive validity. Construct validity: There were moderate correlations between the EFPT and the NIH Toolbox Crystallized (r = -.479), Fluid Tests (r = -.420), and Total Composite Scores (r = -.496). Discriminant validity: Significant differences were found in the EFPT total and sequence scores across control, complicated mild/moderate, and severe TBI groups. We found differences in the organisation score between control and severe, and between mild and severe TBI groups. Both TBI groups had significantly lower scores in safety and judgement than controls. Compared to the controls, the severe TBI group demonstrated significantly lower performance on all instrumental activities of daily living (IADL) tasks. Compared to the mild TBI group, the controls performed better on the medication task, the severe TBI group performed worse in the cooking and telephone tasks. Predictive validity: The EFPT predicted the self-perception of independence measured by the TBI-QOL (beta = -0.49, p < .001) for the severe TBI group. Overall, these data support the validity of the EFPT for use in individuals with TBI.

Motion-based virtual reality cognitive training targeting executive functions in acquired brain injury community-dwelling individuals: A feasibility and initial efficacy pilot

“…Executive Function Performance Test (EFPT) -Bill Paying subtest [42], [43]. A performance-based assessment of EF.…”

Development and Psychometric Characteristics of the TBI-QOL Independence Item Bank and Short Form and the TBI-QOL Asking for Help Scale

“…Fit of each of the measures to a unidimensional CFA model and to the GRM IRT model provide evidence of the internal or structural validity of the measures. Evidence supporting construct validity was reported by Baum et al, 59 who found that participants with severe TBI who had higher scores on a functional performance test also had higher TBI-QOL Independence scores. Future work evaluating changes in scores over time or in response to interventions designed to improve independence would provide further support for the validity of the TBI-QOL Independence and Asking for Help measures.…”

Special issue on ecological validity and cognitive assessment

“…The term ecological validity is used here to refer to generalisability (veridicality, or the extent to which assessment results relate to and/or predict behaviours outside the test environment) and representativeness (verisimilitude, or the degree to which assessments resemble everyday life contexts in which the behaviours will be needed). While not the original meaning of the term (see Burgess et al, 2006 for discussion andBaum et al, 2017), it is the meaning that is now in general use.…”

“…Additional content on two of the measures cited by Poncet et al is provided in three papers in this volume. Baum et al (2017) show data on the validity and clinical utility of Executive Function Performance Test in a large sample of adults with traumatic brain injury. Clark, Anderson, Nalder, Arshad and Dawson (2017) and Nalder, Clark, Anderson and Dawson (2017) add to a growing literature on the psychometric characteristics and clinical utility data of the Multiple Errands Test (MET).…”