Assessment of executive functioning in patients with meningioma and low-grade glioma: A comparison of self-report, proxy-report, and test performance

Sophie van der Linden*, Karin Gehring, Wouter De Baene, Wilco Emons, Geert-Jan Rutten, Margriet Sitskoorn

*Corresponding author for this work

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Abstract

Objective:
This study aimed to examine: (1) patient–proxy agreement on executive functioning (EF) of patients with primary brain tumors, (2) the relationships between patient- and proxy-report with performance-based measures of EF, and (3) the potential influence of performance-based measures on the level of agreement.

Methods:
Meningioma and low-grade glioma patients and their informal caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF-A) 3 months after surgery. The two index scores of the BRIEF-A, Behavioral Regulation and Metacognition, were evaluated. Mean scores of patients and proxies were compared with normative values and with each other. Patient–proxy agreement was evaluated with Lin’s concordance correlation coefficients (CCCs) and Bland–Altman plots. Pearson correlation coefficients between reported EF and performance-based measures of EF were calculated. Multiple regression analysis was used to evaluate the potential influence of test performance on differences in dyadic reports.

Results:
A total of 47 dyads were included. Patients reported significantly more problems on the Metacognition Index compared to norms, and also in comparison with their proxies. Effect sizes indicated small differences. Moderate to substantial agreement was observed between patients and proxies, with CCCs of 0.57 and 0.61 for Metacognition and Behavioral Regulation, respectively. Correlations between reported EF and test performance ranged between −0.37 and 0.10. Dyadic agreement was not significantly influenced by test performance.

Conclusions:
Patient–proxy agreement was found to be moderate. No clear associations were found between reported EF and test performance. Future studies should further explore the existing and new methods to assess everyday EF in brain tumor patients.
Original languageEnglish
JournalJINS. Journal of the International Neuropsychological Society
DOIs
Publication statusE-pub ahead of print - 2020

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Meningioma
Proxy
Glioma
Self Report
Executive Function
Caregivers
Equipment and Supplies

Cite this

@article{e2c1d66a50d64959af2366cbb6860f34,
title = "Assessment of executive functioning in patients with meningioma and low-grade glioma: A comparison of self-report, proxy-report, and test performance",
abstract = "Objective:This study aimed to examine: (1) patient–proxy agreement on executive functioning (EF) of patients with primary brain tumors, (2) the relationships between patient- and proxy-report with performance-based measures of EF, and (3) the potential influence of performance-based measures on the level of agreement.Methods:Meningioma and low-grade glioma patients and their informal caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF-A) 3 months after surgery. The two index scores of the BRIEF-A, Behavioral Regulation and Metacognition, were evaluated. Mean scores of patients and proxies were compared with normative values and with each other. Patient–proxy agreement was evaluated with Lin’s concordance correlation coefficients (CCCs) and Bland–Altman plots. Pearson correlation coefficients between reported EF and performance-based measures of EF were calculated. Multiple regression analysis was used to evaluate the potential influence of test performance on differences in dyadic reports.Results:A total of 47 dyads were included. Patients reported significantly more problems on the Metacognition Index compared to norms, and also in comparison with their proxies. Effect sizes indicated small differences. Moderate to substantial agreement was observed between patients and proxies, with CCCs of 0.57 and 0.61 for Metacognition and Behavioral Regulation, respectively. Correlations between reported EF and test performance ranged between −0.37 and 0.10. Dyadic agreement was not significantly influenced by test performance.Conclusions:Patient–proxy agreement was found to be moderate. No clear associations were found between reported EF and test performance. Future studies should further explore the existing and new methods to assess everyday EF in brain tumor patients.",
author = "{van der Linden}, Sophie and Karin Gehring and {De Baene}, Wouter and Wilco Emons and Geert-Jan Rutten and Margriet Sitskoorn",
year = "2020",
doi = "10.1017/S1355617719001164",
language = "English",
journal = "JINS. Journal of the International Neuropsychological Society",
issn = "1355-6177",
publisher = "Cambridge University Press",

}

TY - JOUR

T1 - Assessment of executive functioning in patients with meningioma and low-grade glioma

T2 - A comparison of self-report, proxy-report, and test performance

AU - van der Linden, Sophie

AU - Gehring, Karin

AU - De Baene, Wouter

AU - Emons, Wilco

AU - Rutten, Geert-Jan

AU - Sitskoorn, Margriet

PY - 2020

Y1 - 2020

N2 - Objective:This study aimed to examine: (1) patient–proxy agreement on executive functioning (EF) of patients with primary brain tumors, (2) the relationships between patient- and proxy-report with performance-based measures of EF, and (3) the potential influence of performance-based measures on the level of agreement.Methods:Meningioma and low-grade glioma patients and their informal caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF-A) 3 months after surgery. The two index scores of the BRIEF-A, Behavioral Regulation and Metacognition, were evaluated. Mean scores of patients and proxies were compared with normative values and with each other. Patient–proxy agreement was evaluated with Lin’s concordance correlation coefficients (CCCs) and Bland–Altman plots. Pearson correlation coefficients between reported EF and performance-based measures of EF were calculated. Multiple regression analysis was used to evaluate the potential influence of test performance on differences in dyadic reports.Results:A total of 47 dyads were included. Patients reported significantly more problems on the Metacognition Index compared to norms, and also in comparison with their proxies. Effect sizes indicated small differences. Moderate to substantial agreement was observed between patients and proxies, with CCCs of 0.57 and 0.61 for Metacognition and Behavioral Regulation, respectively. Correlations between reported EF and test performance ranged between −0.37 and 0.10. Dyadic agreement was not significantly influenced by test performance.Conclusions:Patient–proxy agreement was found to be moderate. No clear associations were found between reported EF and test performance. Future studies should further explore the existing and new methods to assess everyday EF in brain tumor patients.

AB - Objective:This study aimed to examine: (1) patient–proxy agreement on executive functioning (EF) of patients with primary brain tumors, (2) the relationships between patient- and proxy-report with performance-based measures of EF, and (3) the potential influence of performance-based measures on the level of agreement.Methods:Meningioma and low-grade glioma patients and their informal caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF-A) 3 months after surgery. The two index scores of the BRIEF-A, Behavioral Regulation and Metacognition, were evaluated. Mean scores of patients and proxies were compared with normative values and with each other. Patient–proxy agreement was evaluated with Lin’s concordance correlation coefficients (CCCs) and Bland–Altman plots. Pearson correlation coefficients between reported EF and performance-based measures of EF were calculated. Multiple regression analysis was used to evaluate the potential influence of test performance on differences in dyadic reports.Results:A total of 47 dyads were included. Patients reported significantly more problems on the Metacognition Index compared to norms, and also in comparison with their proxies. Effect sizes indicated small differences. Moderate to substantial agreement was observed between patients and proxies, with CCCs of 0.57 and 0.61 for Metacognition and Behavioral Regulation, respectively. Correlations between reported EF and test performance ranged between −0.37 and 0.10. Dyadic agreement was not significantly influenced by test performance.Conclusions:Patient–proxy agreement was found to be moderate. No clear associations were found between reported EF and test performance. Future studies should further explore the existing and new methods to assess everyday EF in brain tumor patients.

U2 - 10.1017/S1355617719001164

DO - 10.1017/S1355617719001164

M3 - Article

JO - JINS. Journal of the International Neuropsychological Society

JF - JINS. Journal of the International Neuropsychological Society

SN - 1355-6177

ER -