Many childhood cancer survivors develop neurocognitive impairment, negatively affecting education and psychosocial functioning. Recommended comprehensive neuropsychological testing can be time- and cost- intensive for both institutions and patients and their families. It is important to find quick and easily administered surveillance measures to identify those in need of evaluation. We evaluated, individually and in combination, the sensitivity and specificity of the 1) Behavior Rating Inventory of Executive Functioning-Metacognition Index (BRIEF-MCI), and 2) CogState Composite Index (computerized assessment of cognition) in identifying below grade-level performance on state-administered tests of reading and mathematics among childhood cancer survivors. The 45 participants (39% female) were a mean age of 7.1 ± 4.4 years at diagnosis, 14.0 ± 3.0 at evaluation, with a history of leukemia (58%), lymphoma (9%), central nervous system tumors (20%), and other tumors (13%). Impairment on the BRIEF-MCI was associated with low sensitivity (26% reading, 41% mathematics) but stronger specificity (88% reading, 96% mathematics). We found similar associations for the CogState Composite Index with sensitivity of 26% for reading and 29% for mathematics and specificity of 92% for both reading and mathematics. Combining the two measures did not improve sensitivity appreciably (47% reading, 59% mathematics) while reducing specificity (84% reading, 88% mathematics). While individuals identified from the BRIEF-MCI or CogState Composite would likely benefit from a full neuropsychological evaluation given the strong specificity, use of these measures as screening tools is limited. With poor sensitivity, they do not identify many patients with academic difficulties and in need of a full neuropsychological evaluation. Continued effort is required to find screening measures that have both strong sensitivity and specificity.

中文翻译：

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监测儿童癌症幸存者的神经认知功能：CogState 计算机化评估和执行功能行为评定量表 (BRIEF) 的评估

许多儿童癌症幸存者出现神经认知障碍，对教育和心理社会功能产生负面影响。对于机构、患者及其家人来说，推荐的综合神经心理学测试可能会耗费大量时间和成本。找到快速且易于管理的监测措施来识别需要评估的人非常重要。我们单独和组合评估了 1) 执行功能行为评级量表-元认知指数 (BRIEF-MCI) 和 2) CogState 综合指数（计算机化认知评估）在识别低于年级水平的表现方面的敏感性和特异性对儿童癌症幸存者进行国家管理的阅读和数学测试。45 名参与者（39% 为女性）诊断时平均年龄为 7.1 ± 4.4 岁，评估时平均年龄为 14.0 ± 3.0 岁，有白血病病史 (58%)、淋巴瘤病史 (9%)、中枢神经系统肿瘤病史 (20%)和其他肿瘤（13%）。Brief-MCI 的损伤与低敏感性（26% 读数，41% 数学）有关，但特异性较强（88% 读数，96% 数学）。我们发现 CogState 综合指数存在类似的关联，阅读敏感性为 26%，数学敏感性为 29%，阅读和数学特异性均为 92%。结合这两种测量方法并没有显着提高敏感性（47% 读数，59% 数学），同时降低了特异性（84% 读数，88% 数学）。虽然从 Brief-MCI 或 CogState Composite 中识别出的个人可能会受益于全面的神经心理学评估，因为其具有很强的特异性，但使用这些措施作为筛查工具是有限的。由于敏感性较差，他们无法识别出许多有学业困难且需要全面神经心理学评估的患者。需要继续努力寻找具有较强敏感性和特异性的筛查措施。