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Pinto JO, Dores AR, Peixoto B, Barbosa F. Ecological validity in neurocognitive assessment: Systematized review, content analysis, and proposal of an instrument. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-18. [PMID: 36755377 DOI: 10.1080/23279095.2023.2170800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVES The main objectives of this study are to identify the dimensions of Ecological Validity (EV) within the definitions of this concept, understand how they are operationalized in neurocognitive tests, and propose a checklist for EV attributes in neurocognitive tests. METHOD A systematized review was combined with content analysis of the selected papers, using the inductive method. We analyzed 82 studies on the EV of neurocognitive tests, 19 literature reviews and 63 empirical studies. Based on this review, we identified the relevant criteria for evaluating EV. RESULTS EV is a multidimensional concept with two main dimensions: representativeness and generalization. Representativeness involves the subdimensions simplicity-complexity and artificial-natural and several criteria organized on a continuum from low EV to high EV. Generalization is dependent on representativeness and is influenced by different cognitive and non-cognitive factors. We propose six stages for operationalizing EV, from defining the objectives of the neurocognitive assessment to the methodology for scoring and interpreting the results. CONCLUSION This systematized review helps to operationalize the concept of EV by providing a tool for evaluating and improving EV while developing new tests. Further studies with a longitudinal design can compare the predictive value of tests with higher versus lower EV-checklist scores.Key pointsQuestion: Understand the definition of EV, its dimensions and subdimensions, how EV is operationalized in neurocognitive tests and propose a checklist for the EV attributes of neurocognitive tests.Findings: The primary findings were that representativeness and generalization are the main dimensions of EV. Representativeness involves several subdimensions, whereas generalization is dependent on representativeness and is influenced by cognitive and non-cognitive factors. We provided an EV-checklist organized into six parts.Importance: The EV-checklist can be used to guide the development of ecologically valid neurocognitive tests and/or assess the EV of existing ones.Next steps: Examine the predictive value of tests that have higher EV-checklist scores.
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Affiliation(s)
- Joana O Pinto
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- CESPU, University Institute of Health Sciences, Gandra, Portugal
| | - Artemisa R Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- Center for Rehabilitation Research, ESS, Polytechnic of Porto, Porto, Portugal
| | - Bruno Peixoto
- CESPU, University Institute of Health Sciences, Gandra, Portugal
- NeuroGen, Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- TOXRUN - Toxicology Research Unit, University Institute of Health Sciences, CESPU, Gandra, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Wilbers M, Geusgens C, van Heugten CM. Assessing learning potential in elderly stroke patients: The validity of the dynamic Clock Drawing Task in comparison with the dynamic Wisconsin Card Sorting Test. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-11. [PMID: 36726234 DOI: 10.1080/23279095.2023.2171794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Currently, there is no valid and feasible dynamic test available for assessing learning potential in elderly stroke patients. We designed a dynamic version of the Clock Drawing Task (dCDT) which we compared to the dynamic Wisconsin Card Sorting Test (dWCST). The dWCST has shown adequate validity in adult patients with brain injury but has a long administration time. Participants were 47 stroke patients admitted to a geriatric rehabilitation unit. All participants completed the dCDT, the mean administration time was 7 min. 90.7% of the participants were able to complete the dWCST, the mean administration time was 36 min. The numerical learning potential indices of the dCDT were not significantly correlated. Based on the dCDT, 70.2% of the participants were classified as high achiever, 10.6% as strong learner, 19.2% as poor learner, and none as decliner. The numerical learning potential indices of the dWCST correlated significantly. Based on the dWCST, 5.3% of the participants were classified as high achiever, 42.1% as strong learner, 50% as poor learner, and 2.6% as decliner. The learning potential indices of the dCDT and those of the dWCST were not significantly correlated, indicating poor convergent validity of the dCDT. The results provide no clear support for the use of the dCDT in elderly stroke patients. The dWCST does show adequate validity and feasibility in the elderly stroke population, despite longer administration time. Future research should focus on examining the validity of the dCDT in a larger sample as well as examining the predictive validity of the dWCST.
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Affiliation(s)
- Martine Wilbers
- Department of Clinical and Medical Psychology, Zuyderland Medical Center, Geleen, the Netherlands
| | - Chantal Geusgens
- Department of Clinical and Medical Psychology, Zuyderland Medical Center, Geleen, the Netherlands
| | - Caroline M van Heugten
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Neuropsychology & Psychopharmacology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Limburg Brain Injury Center, Maastricht University, Maastricht, the Netherlands
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Assessment of Executive Function in Patients with Traumatic Brain Injury with the Wisconsin Card-Sorting Test. Brain Sci 2020; 10:brainsci10100699. [PMID: 33019772 PMCID: PMC7600451 DOI: 10.3390/brainsci10100699] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 08/23/2020] [Accepted: 08/24/2020] [Indexed: 11/17/2022] Open
Abstract
This review aimed at providing a brief and comprehensive summary of recent research regarding the use of the Wisconsin Card-Sorting Test (WCST) to assess executive function in patients with traumatic brain injury (TBI). A bibliographical search, performed in PubMed, Web of Science, Scopus, Cochrane Library, and PsycInfo, targeted publications from 2010 to 2020, in English or Spanish. Information regarding the studies’ designs, sample features and use of the WCST scores was recorded. An initial search eliciting 387 citations was reduced to 47 relevant papers. The highest proportion of publications came from the United States of America (34.0%) and included adult patients (95.7%). Observational designs were the most frequent (85.1%), the highest proportion being cross-sectional or case series studies. The average time after the occurrence of the TBI ranged from 4 to 62 years in single case studies, and from 6 weeks up to 23.5 years in the studies with more than one patient. Four studies compared groups of patients with TBI according to the severity (mild, moderate and/or severe), and in two cases, the studies compared TBI patients with healthy controls. Randomized control trials were seven in total. The noncomputerized WCST version including 128 cards was the most frequently used (78.7%). Characterization of the clinical profile of participants was the most frequent purpose (34.0%). The WCST is a common measure of executive function in patients with TBI. Although shorter and/or computerized versions are available, the original WCST with 128 cards is still used most often. The WCST is a useful tool for research and clinical purposes, yet a common practice is to report only one or a few of the possible scores, which prevents further valid comparisons across studies. Results might be useful to professionals in the clinical and research fields to guide them in assessment planning and proper interpretation of the WCST scores.
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Miranda AR, Franchetto Sierra J, Martínez Roulet A, Rivadero L, Serra SV, Soria EA. Age, education and gender effects on Wisconsin card sorting test: standardization, reliability and validity in healthy Argentinian adults. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:807-825. [PMID: 31744387 DOI: 10.1080/13825585.2019.1693491] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The Wisconsin Card Sorting Test (WCST) is a widely used neuropsychological assessment of executive functioning. The aim of this study was to provide norm values and analyze the psychometric properties of WCST in healthy Argentinian adults aged from 18 to 89 years old (N = 235). Descriptive statistics are reported as means, standard deviations and percentiles, with the effects of age, education and gender being investigated by ANOVA, and with the effect sizes being calculated. The psychometrics were studied using the WCST structure, reliability, convergent validity, and discriminant validity, and WCST norms adjusted for age and educational level are proposed. This instrument is a reliable and valid tool for the assessment of executive functions. However, as the age- and educational-related effects were demonstrated, these characteristics need to be considered before interpreting WCST scores. Regarding gender, no differences were found. Our results expand the geographical and sociocultural applicability of WCST.
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Affiliation(s)
- Agustín R Miranda
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA , Córdoba, Argentina
| | - Juliana Franchetto Sierra
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Amparo Martínez Roulet
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Luisina Rivadero
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Silvana V Serra
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología. Córdoba, Universidad Nacional de Córdoba , Cordoba, Argentina
| | - Elio A Soria
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA , Córdoba, Argentina.,Universidad Nacional de Córdoba, Facultad de Ciencias Médicas, Cátedra de Biología Celular, Histología y Embriología, Instituto de Biología Celular , Cordoba, Argentina
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Chiu EC, Wu WC, Hung JW, Tseng YH. Validity of the Wisconsin Card Sorting Test in patients with stroke. Disabil Rehabil 2017; 40:1967-1971. [DOI: 10.1080/09638288.2017.1323020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- En-Chi Chiu
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wen-Chi Wu
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Jen-Wen Hung
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Hsuan Tseng
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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