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.