Screening and Assessment for Cognitive Problems

2021 ◽  
pp. 146-152
Author(s):  
Alexandra M. Gaynor ◽  
James C. Root ◽  
Elizabeth Ryan ◽  
Tim A. Ahles
Keyword(s):  
Cancer Survivors ◽  
Cognitive Dysfunction ◽  
Sensitivity And Specificity ◽  
Neuropsychological Assessment ◽  
Objective Measures ◽  
Future Research ◽  
Cognitive Screening ◽  
Cognitive Domains ◽  
Impact Performance ◽  
Cognitive Problems

Cancer-associated cognitive dysfunction (CACD) is experienced by up to two-thirds of cancer survivors and may persist for decades following completion of treatment. Cognitive dysfunction in survivors may be subtle and may impact performance in or more cognitive domains; therefore, there is a need for objective measures of function that have adequate sensitivity and specificity to detect cognitive decline in this population. This chapter discusses brief cognitive screening measures and their utility in detecting dysfunction, as well as more comprehensive flexible neuropsychological assessment measures and their use in cancer survivors. The chapter provides a review of research examining the sensitivity and specificity of these measures in the detection of CACD, as well as their effect on patient outcomes, and provides recommendations for future research and the use of flexible neuropsychological assessment batteries in the screening and assessment of CACD.

Operating Characteristics of the neurobehavioral cognitive Status Exam Using Neuropsychological Assessment as the Criterion

Assessment ◽  
1997 ◽  
Vol 4 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Peter Karzmark
Keyword(s):  
Cognitive Dysfunction ◽  
Sensitivity And Specificity ◽  
Neuropsychological Assessment ◽  
Cognitive Abilities ◽  
Cognitive Status ◽  
Performance Characteristics ◽  
Operating Characteristics ◽  
The Individual ◽  
Specific Cognitive Abilities

This study examined the performance characteristics of the Neurobehavioral Cognitive Status Exam (NCSE) using comprehensive neuropsychological assessment as the criterion. Sensitivity and specificity were assessed for the NCSE as a whole and for the individual subtests as measures of discrete cognitive abilities. The sample consisted of 50 consecutive outpatient referrals to the neuropsychological assessment service of a general medical hospital. Most of the patients in the sample had mild or moderate cognitive dysfunction. The sensitivity and specificity of the NCSE as a whole were .74 and .86, respectively. The sensitivity of the individual NCSE subtests was lower, ranging from .20 to .48. Specificity of subtests was high (.64 to .97). The results suggest that the operating characteristics of the NCSE depend significantly on the severity and nature of the sample assessed and the criterion used. They also indicate the need for caution in using NCSE subtest performance as a basis for concluding that specific cognitive abilities are normal.

Cancer and Cancer Treatment-Related Cognitive Impairment

2019 ◽  
pp. 60-83
Author(s):  
James C.  Root ◽  
Elizabeth Ryan ◽  
Tim A. Ahles
Keyword(s):  
Cancer Survivors ◽  
Cancer Treatment ◽  
Clinical Presentation ◽  
Functional Neuroimaging ◽  
Theoretical Models ◽  
Future Research ◽  
Cognitive Changes ◽  
Central Nervous System Cancer ◽  
Pharmacologic Treatments

As the population of cancer survivors has grown into the millions, there is increasing emphasis on understanding how late effects of treatment impact survivors’ ability return to work/school, ability to function and live independently, and overall quality of life. Cognitive changes are one of the most feared problems among cancer survivors. This chapter describes the growing literature examining cognitive changes associated with non-central nervous system cancer and cancer treatment. Typical elements of cancer treatment are discussed, followed by a description of clinical presentation, self-reported and objectively assessed cognitive findings, and results of structural and functional neuroimaging research. Genetic and other risk factors for cognitive decline following treatment are identified and discussed, together with biomarkers and animal models of treatment-related effects. This is followed by a discussion of behavioral and pharmacologic treatments. Finally, challenges and recommendations for future research are provided to help guide subsequent research and theoretical models.

scholarly journals SAT0623-HPR THE LIVED EXPERIENCES OF COGNITIVE DYSFUNCTION IN ADULTS WITH FIBROMYALGIA: A QUALITATIVE SYSTEMATIC REVIEW

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1271.1-1272
Author(s):  
S. Derham ◽  
J. Lewis ◽  
E. Dures ◽  
F. Cramp
Keyword(s):  
Clinical Practice ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Lived Experiences ◽  
Critical Appraisal ◽  
Negative Impact ◽  
Practice Research ◽  
Future Research ◽  
Poor Sleep ◽  
Cognitive Changes

Background:Adults with fibromyalgia frequently report symptoms of cognitive dysfunction, often referred to as fibrofog. However primary research exploring cognitive dysfunction in the lives of adults with fibromyalgia is very limited (Kravitz and Katz, 2015).Objectives:The aim of this review was to (i) synthesise the qualitative literature on the lived experiences of cognitive dysfunction in adults with fibromyalgia, (ii) develop common themes through thematic analysis and (iii) identify knowledge gaps to inform future research and clinical practice in this area.Methods:Seven electronic databases (MEDLINE, Embase, CINAHL, PsycINFO, Amed, Scopus and OpenGrey), reference lists of key articles and two high impact qualitative journals were searched from 1990 to November 2018. Articles were eligible for inclusion if they reported primary qualitative data exploring the experiences of cognitive dysfunction in adults with fibromyalgia. Included studies were appraised using the Critical Appraisal Skills Programme (CASP) qualitative checklist and extracted data analysed using narrative synthesis. SD conducted critical appraisal and data extraction on all included studies. FC, JL and ED reviewed five papers each. All papers were reviewed by two co-authors. Of the 1413 records identified, 15 studies were selected for inclusion.Results:These studies included 208 women and 22 men with fibromyalgia, aged 18 to 72 years and representing seven different countries. Duration of diagnosis was four months to 34 years. Fourteen studies used interviews and one used focus groups. None of the included studies focussed exclusively on cognitive function in adults with fibromyalgia. Three studies identified themes specific to cognitive dysfunction and fibromyalgia symptoms. The remaining 12 studies presented relevant data intertwined with the overall lived experiences of fibromyalgia.Cognitive dysfunction, as a part of fibromyalgia, was often unpredictable. Problems with memory and concentration that were most commonly reported were emotionally distressing and affected functional and vocational activities. Participants found communication effortful, with a negative impact on work, leisure and social activities. Stress, fear and worry around perceived cognitive changes were commonly expressed. Lost employment or changed work roles and relationships, due to cognitive difficulties, had negative impacts for many participants. The terms cognitive dysfunction and fibrofog were used interchangeably within the studies, but lacked common definition. This introduced uncertainty around whether participants and authors were describing the same phenomenon.Conclusion:Adults with fibromyalgia experience unpredictable and emotionally impactful difficulties related to cognitive dysfunction. Functional impact was broad-reaching, particularly around work ability and lost employment opportunities. It is unclear how cognitive symptoms in fibromyalgia related to co-morbid symptoms such as pain, fatigue and poor sleep. Further research focusing on the full impact of cognitive function on the lives of adults with fibromyalgia is recommended to inform clinical practice. Research to establish clarity of definition of the terms cognitive dysfunction and fibrofog within fibromyalgia is highly recommended.References:[1]Kravitz H, Katz R. Fibrofog and fibromyalgia: a narrative review and implications for clinical practice. Rheumatology International. 2015;35(7):1115-25.Acknowledgments:This work is supported by the National Institute for Heath Research [ICA-PCAF-2018-01-078 to SD]Disclosure of Interests:Sandra Derham: None declared, Jenny Lewis: None declared, Emma Dures Grant/research support from: Independent Learning Grant from Pfizer, combined funding for a research fellow from Celgene, Abbvie and Novartis, Paid instructor for: A fee from Novartis to deliver training to nurses., Fiona Cramp: None declared

319 Validation of the Insomnia Severity Index Short-Form for Identifying Insomnia Disorder in Young Adult Cancer Survivors

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A128-A128
Author(s):  
Lydia Chevalier ◽  
Alexis Michaud ◽  
Eric Zhou ◽  
Grace Chang ◽  
Christopher Recklitis
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Sensitivity And Specificity ◽  
Short Form ◽  
A Priori ◽  
Severity Index ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer ◽  
Insomnia Severity

Abstract Introduction Insomnia is a common and impairing late effect experienced by many young adult cancer survivors (YACS). Although routine evaluation of sleep disorders in cancer survivors is recommended, lack of consensus on appropriate screening measures contributes to under-identification and under-treatment of these disorders in YACS. As screening measures are ideally as brief as possible while maintaining validity, we sought to validate the recently published three-item Insomnia Severity Index Short-Form (ISI-SF) in YACS. Methods 250 YACS completed the ISI and the Structured Clinical Interview for the DSM-5 (SCID-5). The ISI-SF was created by summing three ISI items: distress (item #6), interference (item #7), and satisfaction (item #4). In receiver operating characteristic (ROC) analyses, area under the curve (AUC) was calculated to compare discrimination on the ISI-SF to two criteria: the full-scale ISI using a cutoff of ≥8 recently validated in this sample, and the SCID-5 insomnia module. Consistent with previous research, we specified a priori that a cut-off score on the ISI-SF with sensitivity ≥.85 and specificity ≥.75 would be acceptable. Results The ISI-SF had excellent discrimination when compared to the full-scale ISI (AUC = .97) and a cut-off score of ≥4 met criteria with a sensitivity of 97% and specificity of 86%. The ISI-SF had good discrimination when compared to the SCID-5 (AUC = .88), but none of the cut-off scores met a priori criteria for sensitivity and specificity. A cut-off score of ≥4 came closest with a sensitivity of 94% and specificity of 70%. Conclusion Although the ISI-SF did not meet sensitivity and specificity criteria for a stand-alone screening measure when compared to a diagnostic interview, it demonstrated utility as the first step in a two-step screening procedure. Specifically, the high sensitivity of the ≥4 ISI-F cut-off score is well-suited to accurately screening out YACS who do not need insomnia services; as a second screen, the SCID-5 insomnia module could be administered only to those elevated on the ISI-SF in order to identify false positives cases before making referrals for insomnia specialists. Support (if any) National Cancer Institute (1R21CA223832), Swim Across America

scholarly journals SaQuant: a real-time PCR assay for quantitative assessment of Staphylococcus aureus

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Colin Wood ◽  
Jason Sahl ◽  
Sara Maltinsky ◽  
Briana Coyne ◽  
Benjamin Russakoff ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Sensitivity And Specificity ◽  
Pathogen Detection ◽  
Limit Of Detection ◽  
Future Research ◽  
Limit Of Quantification ◽  
Pathogen Prevalence ◽  
Single Well ◽  
Effective Public Health ◽  
Detection And Quantification

Abstract Background Molecular assays are important tools for pathogen detection but need to be periodically re-evaluated with the discovery of additional genetic diversity that may cause assays to exclude target taxa or include non-target taxa. A single well-developed assay can find broad application across research, clinical, and industrial settings. Pathogen prevalence within a population is estimated using such assays and accurate results are critical for formulating effective public health policies and guiding future research. A variety of assays for the detection of Staphylococcus aureus are currently available. The utility of commercial assays for research is limited, given proprietary signatures and lack of transparent validation. Results In silico testing of existing peer-reviewed assays show that most suffer from a lack of sensitivity and specificity. We found no assays that were specifically designed and validated for quantitative use. Here we present a qPCR assay, SaQuant, for the detection and quantification of S. aureus as might be collected on sampling swabs. Sensitivity and specificity of the assay was 95.6 and 99.9 %, respectively, with a limit of detection of between 3 and 5 genome equivalents and a limit of quantification of 8.27 genome equivalents. The presence of DNA from non-target species likely to be found in a swab sample, did not impact qualitative or quantitative abilities of the assay. Conclusions This assay has the potential to serve as a valuable tool for the accurate detection and quantification of S. aureus collected from human body sites in order to better understand the dynamics of prevalence and transmission in community settings.

Sub-Ethnicity and Survivorship Experience: Asian American Breast Cancer Survivors

2021 ◽  
pp. 019394592110319
Author(s):  
Wonshik Chee ◽  
Eun-Ok Im
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Asian American ◽  
Breast Cancer Survivors ◽  
Short Form ◽  
Secondary Analysis ◽  
Future Research ◽  
Japanese American ◽  
Personal Resource ◽  
Cancer Data

The purpose of the study was to explore the associations of sub-ethnicity to the survivorship experience of Asian American breast cancer survivors and identify the multiple factors that influenced their survivorship experience. This was a secondary analysis of the data among 94 Asian American breast cancer survivors from a larger ongoing study. Instruments included: questions on background characteristics, the perceived isolation scale, the Personal Resource Questionnaire, the Memorial Symptom Assessment Scale-Short Form, and the Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using hierarchical logistic and multiple regression analyses. After controlling for other factors, being a Japanese American (ref. = being a Chinese American) was significantly associated with pain scores (odds ratio [OR] = −0.32, p < .01), symptom distress scores ( β = −0.27, p < .01), and the quality of life scores ( β = 0.22, p = .03). Sub-ethnic variations in cultural attitudes, values, and beliefs need to be considered in future research/practice with Asian American breast cancer survivors.

scholarly journals Cognitive Assessments in Hydration Research Involving Children: Methods and Considerations

2019 ◽  
Vol 74 (Suppl. 3) ◽  
pp. 19-24 ◽  
Author(s):  
Daniel R. Westfall ◽  
Nicole E. Logan ◽  
Naiman A. Khan ◽  
Charles H. Hillman
Keyword(s):  
Academic Achievement ◽  
Human Health ◽  
Research Interest ◽  
Future Research ◽  
Cognitive Assessments ◽  
Cognitive Domains ◽  
Essential Nutrient ◽  
Definition Of ◽  
The Relationship

The effects of optimal and insufficient hydration on human health have received increasing investigation in recent years. Specifically, water is an essential nutrient for human health, and the importance of hydration on cognition has continued to attract research interest over the last decade. Despite this focus, children remain a relatively understudied population relative to the effects of hydration on cognition. Of those studies investigating children, findings have been inconsistent, resulting from utilizing a wide variety of cognitive domains and cognitive assessments, as well as varied hydration protocols. Here, our aim is to create a primer for assessing cognition during hydration research in children. Specifically, we review the definition of cognition and the domains of which it is composed, how cognition has been measured in both field- and laboratory-based assessments, results from neuroimaging methods, and the relationship between hydration and academic achievement in children. Lastly, future research considerations are discussed.

scholarly journals mHealth Interventions to Address Physical Activity and Sedentary Behavior in Cancer Survivors: A Systematic Review

2021 ◽  
Vol 18 (11) ◽  
pp. 5798
Author(s):  
Selina Khoo ◽  
Najihah Mohbin ◽  
Payam Ansari ◽  
Mahfoodha Al-Kitani ◽  
Andre Matthias Müller
Keyword(s):  
Physical Activity ◽  
Cancer Survivors ◽  
Sedentary Behavior ◽  
Total Activity ◽  
Personal Contact ◽  
Future Research ◽  
Controlled Trials ◽  
Cancer Types ◽  
Study Participants ◽  
Multicomponent Interventions

This review aimed to identify, evaluate, and synthesize the scientific literature on mobile health (mHealth) interventions to promote physical activity (PA) or reduce sedentary behavior (SB) in cancer survivors. We searched six databases from 2000 to 13 April 2020 for controlled and non-controlled trials published in any language. We conducted best evidence syntheses on controlled trials to assess the strength of the evidence. All 31 interventions included in this review measured PA outcomes, with 10 of them also evaluating SB outcomes. Most study participants were adults/older adults with various cancer types. The majority (n = 25) of studies implemented multicomponent interventions, with activity trackers being the most commonly used mHealth technology. There is strong evidence for mHealth interventions, including personal contact components, in increasing moderate-to-vigorous intensity PA among cancer survivors. However, there is inconclusive evidence to support mHealth interventions in increasing total activity and step counts. There is inconclusive evidence on SB potentially due to the limited number of studies. mHealth interventions that include personal contact components are likely more effective in increasing PA than mHealth interventions without such components. Future research should address social factors in mHealth interventions for PA and SB in cancer survivors.

scholarly journals Clinical significance of small molecule metabolites in the blood of patients with different types of liver injury

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hui Li ◽  
Yan Wang ◽  
Shizhao Ma ◽  
Chaoqun Zhang ◽  
Hua Liu ◽  
...  
Keyword(s):  
Oleic Acid ◽  
Clinical Diagnosis ◽  
Sensitivity And Specificity ◽  
Acid Amide ◽  
Hbv Infection ◽  
Diagnostic Sensitivity ◽  
Future Research ◽  
Diagnostic Efficacy ◽  
Metabolic Markers ◽  
Diagnostic Sensitivity And Specificity

AbstractTo understand the characteristic of changes of serum metabolites between healthy people and patients with hepatitis B virus (HBV) infection at different stages of disease, and to provide reference metabolomics information for clinical diagnosis of liver disease patients. 255 patients with different stages of HBV infection were selected. 3 mL blood was collected from each patient in the morning to detect differences in serum lysophosphatidylcholine, acetyl-l-carnitine, oleic acid amide, and glycocholic acid concentrations by UFLC-IT-TOF/MS. The diagnostic values of four metabolic substances were evaluated by receiver operating characteristic (ROC) curve. The results showed that the optimal cut-off value of oleic acid amide concentration of the liver cirrhosis and HCC groups was 23.6 mg/L, with a diagnostic sensitivity of 88.9% and specificity of 70.6%. The diagnostic efficacies of the three substances were similar in the hepatitis and HCC groups, with an optimal cut-off value of 2.04 mg/L, and a diagnostic sensitivity and specificity of 100% and 47.2%, respectively. The optimal cut-off value of lecithin of the HBV-carrier and HCC groups was 132.85 mg/L, with a diagnostic sensitivity and specificity of 88.9% and 66.7%, respectively. The optimal cut-off value of oleic acid amide of the healthy and HCC groups was 129.03 mg/L, with a diagnostic sensitivity and specificity of 88.4% and 83.3%, respectively. Lysophosphatidylcholine, acetyl-l-carnitine, and oleic acid amide were potential metabolic markers of HCC. Among them, lysophosphatidylcholine was low in the blood of HCC patients, and its diagnostic efficacy was better than that of acetyl-l-carnitine and oleic acid amide, providing reference metabolomics information in clinical diagnosis and future research.

scholarly journals Deep learning for pulmonary embolism detection on computed tomography pulmonary angiogram: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shelly Soffer ◽  
Eyal Klang ◽  
Orit Shimon ◽  
Yiftach Barash ◽  
Noa Cahan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
Deep Learning ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Future Research ◽  
Learning Models ◽  
Summary Receiver Operating Characteristic ◽  
Pulmonary Angiogram

AbstractComputed tomographic pulmonary angiography (CTPA) is the gold standard for pulmonary embolism (PE) diagnosis. However, this diagnosis is susceptible to misdiagnosis. In this study, we aimed to perform a systematic review of current literature applying deep learning for the diagnosis of PE on CTPA. MEDLINE/PUBMED were searched for studies that reported on the accuracy of deep learning algorithms for PE on CTPA. The risk of bias was evaluated using the QUADAS-2 tool. Pooled sensitivity and specificity were calculated. Summary receiver operating characteristic curves were plotted. Seven studies met our inclusion criteria. A total of 36,847 CTPA studies were analyzed. All studies were retrospective. Five studies provided enough data to calculate summary estimates. The pooled sensitivity and specificity for PE detection were 0.88 (95% CI 0.803–0.927) and 0.86 (95% CI 0.756–0.924), respectively. Most studies had a high risk of bias. Our study suggests that deep learning models can detect PE on CTPA with satisfactory sensitivity and an acceptable number of false positive cases. Yet, these are only preliminary retrospective works, indicating the need for future research to determine the clinical impact of automated PE detection on patient care. Deep learning models are gradually being implemented in hospital systems, and it is important to understand the strengths and limitations of these algorithms.

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