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Parent-reported cognition of children with cancer and its potential clinical usefulness
Jin-Shei Lai1, Frank Zelko, Kevin R Krull
1Medical Social Sciences and Pediatrics, Feinberg School of Medicine at Northwestern University, 633 N St Clair, #19-039, Chicago, IL, 60611, USA, js-lai@northwestern.edu.
Insights
Perceived cognitive function (PCF) screening effectively identifies cognitive issues in pediatric cancer survivors, differentiating those with brain tumors from the general population. This economical tool aids in identifying children needing further cognitive testing.
Area of Science:
- Pediatric Oncology
- Neuropsychology
- Child Psychology
Background:
- Cognitive dysfunction is a significant concern for children undergoing cancer treatment or with brain tumors.
- Perceived cognitive function (PCF) offers a cost-effective method for screening cognitive difficulties.
- Validating PCF against objective measures is crucial for its clinical application.
Purpose of the Study:
- To assess the clinical utility of parent-reported perceived cognitive function (PCF) in children with cancer.
- To compare PCF scores in pediatric cancer patients with the general US population.
- To evaluate PCF's ability to differentiate subgroups of children with cancer.
Main Methods:
- Utilized the pediatric PCF item bank (pedsPCF) with 515 children undergoing cancer treatment.
- Compared pedsPCF scores with parent-reported data and computer-based neuropsychological tests.
- Employed differential item functioning (DIF) analysis to assess measurement bias.
Main Results:
- No differential item functioning (DIF) was found, supporting pedsPCF's use in cancer populations.
- PCF scores effectively differentiated children with brain tumors (BTs) and by years since diagnosis.
- PCF scores correlated significantly with objective neuropsychological tests in 40 of 60 comparisons.
Conclusions:
- Parent-reported perceived cognitive function (PCF) is a valid and sensitive screening tool for pediatric cancer survivors.
- PCF effectively distinguishes between children with varying clinical characteristics, including brain tumors.
- The ease of implementation makes PCF a valuable addition to routine care for pediatric cancer survivors.
Purpose:
Cognitive dysfunction is a common concern for children with brain tumors (BTs) or those receiving central nervous system (CNS) toxic cancer treatments. Perceived cognitive function (PCF) is an economical screening that may be used to trigger full, formal cognitive testing. We assessed the potential clinical utility of PCF by comparing parent-reported scores for children with cancer with scores from the general US population.
Methods:
Children (n = 515; mean age = 13.5 years; 57.0 % male) and one of their parents were recruited from pediatric oncology clinics. Most children (53.3 %) had a diagnosis of CNS tumor with an average time since diagnosis of 5.6 years. PCF was evaluated using the pediatric PCF item bank (pedsPCF), which was developed and normed on a sample drawn from the US general pediatric population. Children also completed computer-based neuropsychological tests. We tested relationships between PCF and clinical variables. Differential item functioning (DIF) was used to evaluate measurement bias between the samples.
Results:
No item showed DIF, supporting the use of pedsPCF in the cancer sample. PedsPCF differentiated children with (vs. without) a BT, p < 0.01, and groups defined by years since diagnosis, p < 0.01. It significantly (p < 0.05) correlated with computerized neuropsychological tests in 40 of 60 comparisons. Children with BTs were rated as having worse pedsPCF scores than the norm, regardless of years since diagnosis.
Conclusions:
PCF significantly differentiated cancer survivors with various clinical characteristics. It is brief and easy to implement. PCF should be considered for routine care of pediatric cancer survivors.
