Assessing Cognitive Function of Breast Cancer Women Using the High Sensitivity Cognitive Screen (HSCS)---A Feasibility and Psychometric Study

One of the side effects after chemotherapy of breast cancer is cognitive impairment which is also known as “chemo-brain”. Previous studied conducted in western countries suggested that this change in cognition is subtle and often ignored by clinical physicians. Comprehensive neuropsychological assessment is considered as the gold standard for diagnosing the cognitive impairment; however it is time consuming and requires trained clinicians to administer the tests and is not suitable for cancer patients who are already experience a great deal of fatigue due to the disease or cancer treatment. Simple screening methods (such as MMSE) may have problem of low sensitivity and, as a result, cause ceiling effect. Development of a highly sensitive and brief instrument for assessing the cognitive function of cancer patients becomes an essential work. The purposes of this research project are to develop the Chinese version of the High Sensitivity Cognitive Screen (HSCS-C) and to test its feasibility and psychometric properties in patients with breast cancer. The project is divided into 4 phases. In Phase I, the main task is to translate the HSCS and adapt it to Chinese culture. Back translation technique and expert review will be employed to ensure the concept equivalence and culture relevancy. In Phase II, the feasibility of the HSCS-C will be tested in 10 breast cancer women and 10 healthy control women. The refusal rate/reason, administration time, and difficulties encountered will be recorded and analyzed. In Phase III, test-retest, practice effect, and inter-rater reliability of the HSCS-C will be estimated with 30 breast cancer women and 30 healthy control women. Another 30 breast cancer women will be recruited to assess the criterion-related validity of the HSCS-C using a battery of standard neuropsychological tests as the gold standard. ROC analysis will be used to identify the best cut-off point of the HSCS-C. In Phase IV, 100 breast cancer women scheduled for chemotherapy will be recruited for repeated measurement. To enhance the clinical interpretation of the HSCS-C, the minimal important change/difference (MID) will be identified using both anchor-based and distribution-based approaches.

Project ID:PC10101-1586
External Project ID:NSC99-2628-B182-030-MY3