Validation of the Pediatric Automated Neuropsychological Assessment Metrics in childhood‐onset systemic lupus erythematosus

Brunner, Hermine I.; Klein‐Gitelman, Marisa S.; Zelko, Frank; Thomas, Erin C.; Hummel, Jessica; Nelson, Shannen; Huggins, Jennifer; Curran, Megan L.; Roebuck-Spencer, Tresa; Beebe, Dean W.; Ying, Jun

doi:10.1002/acr.21835

Cited by 50 publications

(46 citation statements)

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“…Of all of the PedANAM performance parameters, the accuracy score has shown the highest consistency and reliability (16). Additionally, the coefficient of variation of time required for a correct response (CVc) has been proposed as a measure of consistency on the performance of a given PedANAM-subtest (21). …”

Section: Methodsmentioning

confidence: 99%

Cognitive Performance Scores for the Pediatric Automated Neuropsychological Assessment Metrics in Childhood‐Onset Systemic Lupus Erythematosus

Vega‐Fernandez

White

Zelko

et al. 2015

Arthritis Care & Research

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Objective To develop and initially validate a global cognitive performance score for the Pediatric Automated Neuropsychological Assessment Metrics (PedANAM-CPS) to serve as a screening tool of cognition in childhood lupus. Methods Patients (n=166) completed the nine subtests of the PedANAM battery, each of which provides three principal performance parameters (accuracy, mean reaction time for correct responses, throughput). Cognitive ability was measured by formal neurocognitive testing or estimated by the Pediatric Perceived Cognitive Function Questionnaire-43 to determine the presence or absence of neurocognitive dysfunction (NCD). A subset of the data was used to develop four candidate PedANAM-CPS indices with supervised or unsupervised statistical approaches: PedANAM-CPSUWA i.e. unweighted averages of the accuracy scores of all PedANAM-subtests; PedANAM-CPSPCA, i.e. accuracy scores of all PedANAM-subtests weighted through principal components analysis; PedANAM-CPSlogit i.e. algorithm derived from logistic models to estimate NCD-status based on the accuracy scores of all of the PedANAM-subtests; and PedANAM-CPSmultiscore i.e. algorithm derived from logistic models to estimate NCD-status based on select PedANAM performance parameters. Using the remaining data PedANAM-CPS candidates were validated. Results PedANAM-CPS indices were moderately correlated with each other (|r|>0.65). All of the PedANAM-CPS’s discriminated children by NCD-status across datasets (p<0.036). The PedANAM-CPSmultiscore had the highest area under the receiver operating characteristic curve (AUC) across all datasets for identifying NCD-status (AUC >0.74), followed by the PedANAM-CPSlogit, the PedANAM-CPSPCA and the PedANAM-CPSUWA respectively. Conclusions Based on preliminary validation and considering ease of use, the PedANAM-CPSmultiscore and the PedANAM-CPSPCA appear to be best suited as global measures of PedANAM performance.

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Section: Methodsmentioning

confidence: 99%

Cognitive Performance Scores for the Pediatric Automated Neuropsychological Assessment Metrics in Childhood‐Onset Systemic Lupus Erythematosus

Vega‐Fernandez

White

Zelko

et al. 2015

Arthritis Care & Research

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“…Reliability coefficients as low as 0.22 have been reported for the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; ImPACT Applications, Inc, Pittsburgh, PA) 7 and 0.10 for the Automated Neuropsychological Assessment Metrics (ANAM; Vista LifeSciences, Parker, CO). 8 Reliability is an extremely important concept in concussion testing due to individual serial-testing strategies. 9 Reliability refers to the consistency of the scores obtained from a test.…”

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confidence: 99%

“…18 The controversy of CNT reliability is further complicated because of the wide range of reliability estimates (from as low as 0.10 to as high as 0.93) reported across studies. 7,8,11,12,[17][18][19][20][21][22][23][24][25][26][27][28][29][30] Because of the conflicting reports, a more thorough investigation of the reliability of CNT scores is necessary. Although a systematic review 10 summarizing the reliability of ImPACT scores has been previously published, this study was limited to a single CNT.…”

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Reliability of Computerized Neurocognitive Tests for Concussion Assessment: A Meta-Analysis

Farnsworth

Dargo

Ragan³

et al. 2017

Journal of Athletic Training

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Objective: Although widely used, computerized neurocognitive tests (CNTs) have been criticized because of low reliability and poor sensitivity. A systematic review was published summarizing the reliability of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores; however, this was limited to a single CNT. Expansion of the previous review to include additional CNTs and a meta-analysis is needed. Therefore, our purpose was to analyze reliability data for CNTs using meta-analysis and examine moderating factors that may influence reliability.Data Sources: A systematic literature search (key terms: reliability, computerized neurocognitive test, concussion) of electronic databases (MEDLINE, PubMed, Google Scholar, and SPORTDiscus) was conducted to identify relevant studies.Study Selection: Studies were included if they met all of the following criteria: used a test-retest design, involved at least 1 CNT, provided sufficient statistical data to allow for effect-size calculation, and were published in English.Data Extraction: Two independent reviewers investigated each article to assess inclusion criteria. Eighteen studies involving 2674 participants were retained. Intraclass correlation coefficients were extracted to calculate effect sizes and determine overall reliability. The Fisher Z transformation adjusted for sampling error associated with averaging correlations. Moderator analyses were conducted to evaluate the effects of the length of the test-retest interval, intraclass correlation coefficient model selection, participant demographics, and study design on reliability. Heterogeneity was evaluated using the Cochran Q statistic.Data Synthesis: The proportion of acceptable outcomes was greatest for the Axon Sports CogState Test (75%) and lowest for the ImPACT (25%). Moderator analyses indicated that the type of intraclass correlation coefficient model used significantly influenced effect-size estimates, accounting for 17% of the variation in reliability.Conclusions: The Axon Sports CogState Test, which has a higher proportion of acceptable outcomes and shorter test duration relative to other CNTs, may be a reliable option; however, future studies are needed to compare the diagnostic accuracy of these instruments.

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“…7 Paediatric Automated Neuropsychological Assessment Metrics (Ped-ANAM) tasks are automated and various scores are generated for each test to measure patient cognitive ability. We previously showed that of the available Ped-ANAM scores, the a ccuracy score , for example, percentage of correct answers was most affected in patients with cSLE 5…”

Section: Methodsmentioning

confidence: 99%

Blood-based candidate biomarkers of the presence of neuropsychiatric systemic lupus erythematosus in children

et al. 2014

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ObjectiveTo examine select brain-reactive proteins for their usefulness to serve as blood-based biomarkers in the screening for neurocognitive deficits in childhood-onset systemic lupus erythematosus (cSLE-NCD).MethodsPatients withcSLE (n=40) were studied longitudinally (month 1; month 18): working memory, psychomotor speed and visuoconstructional ability were assessed using formal neurocognitive testing to determine the presence of cSLE-NCD. Patients also completed the computerised Paediatric Automated Neuropsychological Assessment Metrics. The following brain-reactive proteins were measured in the blood: neutrophil gelatinase associated lipocalin (NGAL), S100B, S100A8/9, antibodies to NR2 glutamate receptor (aNR2-AB), ribosomal-P (aP-AB), glycoprotein-1 (aGP1-AB), and lupus anticoagulant.ResultscSLE-NCD was present in 6 of 40 patients at baseline and 4 of 27 patients with 18-month information. aP-AB positivity was more commonly present with cSLE-NCD than without (p=0.05). aP-ABs were negatively associated with performance on tests assessing working memory, psychomotor speed and visuoconstructional ability in using formal neurocognitive testing. There were also significant negative associations between aP-AB, S100A8/9, aNR2-AB, aGP1-AB, and lupus anticoagulant and accuracy rates on select Paediatric Automated Neuropsychological Assessment Metrics subtests (p<0.05). Over time, decline in cognitive performance was more pronounced among patients with higher NGAL and aNR2-AB levels. Combinations of serum levels of S100A8/9, S100B, NGAL, aNR2-AB and aP-AB were able to identify cSLE-NCD (sensitivity: 100%; specificity 76%) in exploratory analysis.ConclusionsSelect brain-reactive proteins in the blood are associated with cognitive performance and the presence of cSLE-NCD, cross-sectionally and over time. This raises the possibility that testing of these proteins may assist with the screening of cSLE-NCD.

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Validation of the Pediatric Automated Neuropsychological Assessment Metrics in childhood‐onset systemic lupus erythematosus

Cited by 50 publications

References 34 publications

Cognitive Performance Scores for the Pediatric Automated Neuropsychological Assessment Metrics in Childhood‐Onset Systemic Lupus Erythematosus

Cognitive Performance Scores for the Pediatric Automated Neuropsychological Assessment Metrics in Childhood‐Onset Systemic Lupus Erythematosus

Reliability of Computerized Neurocognitive Tests for Concussion Assessment: A Meta-Analysis

Blood-based candidate biomarkers of the presence of neuropsychiatric systemic lupus erythematosus in children

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