Validation of a Computerized test of Functional Capacity.
Validation of a Computerized test of Functional Capacity.
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DOI：
10.1016/j.schres.2016.03.038
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发表时间：
2016-08
影响因子：
4.5
通讯作者：
Harvey PD
中科院分区：
文献类型：
--
作者：
Keefe RSE;Davis VG;Atkins AS;Vaughan A;Patterson T;Narasimhan M;Harvey PD
精神分裂症认知临床试验的监管指南要求对认知变化的评估附有具有功能意义的终点。然而，目前可用的措施受到变革抵制、心理测量弱点以及基于访谈的评估依赖于线人在场的挑战。当前研究的目的是：1）评估虚拟现实功能能力评估工具（VRFCAT）作为功能能力衡量标准的有效性、敏感性和可靠性； 2) 确定 VRFCAT 性能与 MATRICS 共识认知电池（MCCB）性能之间的关联； 3) 将 VRFCAT 的指标与 UCSD 基于绩效的技能评估 (UPSA) 进行比较。 167 名精神分裂症患者和 166 名健康对照者在基线时完成了 VRFCAT、UPSA 和 MCCB。后续再次完成 VRFCAT 和 UPSA。 VRFCAT、MCCB 和 UPSA 对精神分裂症的损伤非常敏感（d = 1.16 至 1.22）。患者 VRFCAT 总完成时间和 UPSA 总分显示出较高的重测可靠性（ICC 分别为 0.81 和 0.78）。 UPSA 在患者中表现出显着的实践效果 (d=0.35)，而 VRFCAT 则没有 (d=-0.04)。 VRFCAT 总完成时间与 UPSA（r=-0.56，患者 p<0.0001，对照 -0.58，p<0.0001）和 MCCB 综合（r=-0.57，患者 p<0.0001，对照 -0.68，p<0.0001）相关。 VRFCAT 是一种高度可靠且灵敏的功能能力测量方法，与 UPSA 和 MCCB 相关。这些结果为用于精神分裂症的计算机化功能能力评估提供了令人鼓舞的支持。
Regulatory guidance for schizophrenia cognition clinical trials requires that the assessment of cognitive change is accompanied by a functionally meaningful endpoint. However, currently available measures are challenged by resistance to change, psychometric weaknesses, and for interview-based assessments, dependence upon the presence of an informant. The aims of the current study were to: 1) assess the validity, sensitivity, and reliability of the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) as a measure of functional capacity; 2) determine the association between performance on the VRFCAT and performance on the MATRICS Consensus Cognitive Battery (MCCB); and 3) compare the metrics of the VRFCAT with the UCSD Performance-based Skills Assessment (UPSA). 167 patients with schizophrenia and 166 healthy controls completed the VRFCAT, UPSA, and the MCCB at baseline. The VRFCAT and UPSA were completed again at follow-up. The VRFCAT, MCCB, and UPSA were very sensitive to impairment in schizophrenia (d = 1.16 to 1.22). High test-retest reliability was demonstrated for VRFCAT total completion time and the UPSA total score in patients (ICC=0.81 and 0.78, respectively). The UPSA demonstrated significant practice effects in patients (d=0.35), while the VRFCAT did not (d=−0.04). VRFCAT total completion time was correlated with both UPSA (r=−0.56, p<0.0001 for patients and −0.58, p<0.0001 for controls) and MCCB Composite (r=−0.57, p<0.0001 for patients and −0.68, p<0.0001 for controls). The VRFCAT is a highly reliable and sensitive measure of functional capacity with associations to the UPSA and MCCB. These results provide encouraging support for a computerized functional capacity assessment for use in schizophrenia.