Initial Development and Evaluation of the Executive Function Performance Test-Enhanced (EFPT-E) in Women With Cancer-Related Cognitive Impairment.

Abstract

Psychometrically sound instruments are needed to evaluate executive functioning in the population of people with cancer. To develop and evaluate the reliability and validity of the Executive Function Performance Test-Enhanced (EFPT-E) in women after being treated for breast cancer. Cross-sectional. University research laboratory. Women treated for breast cancer who had cognitive impairment (n = 12) and community control participants (n = 13). Evaluators (n = 8) independently scored a recorded administration of the EFPT-E to evaluate interrater reliability. An assessment battery, including the EFPT-E, was administered to evaluate the EFPT-E's known-groups validity and concurrent validity. Excellent interrater reliability was observed for the EFPT-E total score and each subtask score (intraclass correlation coefficient = .90-.98). Moderate effect sizes were noted for the EFPT-E total score (Cohen's d = 0.5) and the total number of cues (d = 0.4) between the breast cancer group and the control group, with the breast cancer group demonstrating poorer performance. A limited correlation was found between the EFPT-E and the other cognitive measures. The results support the EFPT-E's interrater reliability and warrant continued investigation to further establish its reliability and validity. Assessments are needed to quantify the impact of cognitive processes within functional tasks. The EFPT-E has been developed to assess the functional impact of mild cognitive impairment; initial testing with women with cancer showed excellent agreement between raters and promising results for validity.