Initial validation of the Pediatric Automated Neuropsychological Assessment Metrics for childhood-onset systemic lupus erythematosus.
OBJECTIVE
To evaluate the concurrent validity and diagnostic accuracy of the pediatric Automated Neuropsychological Assessment Metrics (Ped-ANAM) when used in childhood-onset systemic lupus erythematosus (SLE).


METHODS
Formal neuropsychological testing and the Ped-ANAM were performed on 27 children with SLE who had not been previously diagnosed with neuropsychiatric SLE. Performance when completing the 10 Ped-ANAM tests was based on accuracy (AC), mean time to correct response, coefficient of variation of the time required for a correct response (CVc), and throughput. Formal neuropsychological testing was used as a criterion standard for diagnosing neurocognitive dysfunction (NCD; yes/no).


RESULTS
NCD was common and present in 16 (59%) of 27 participants. Ped-ANAM performance parameters were often moderately correlated with the Z scores on formal neuropsychological testing. The NCD group differed significantly (P < 0.05) from the normal cognition group in 3 Ped-ANAM tests: CVc with mathematical processing (MTH-CVc), AC with continuous performance test (CPT-AC), and CVc with spatial processing (SPD-CVc). Areas under the receiver operating curves (AUCs) ranged between 0.75 and 0.84 when each of these parameters (CPT-AC, MTH-CVc, SPD-CVc) was used to identify NCD independently. The AUC was improved to 0.96 for the combined assessment.


CONCLUSIONS
The Ped-ANAM has concurrent validity when used in children with SLE. Initial validation suggests that the Ped-ANAM could be a useful screening tool for NCD in children with SLE.
Brunner
Hermine I
HI
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA. hermine.brunner@cchmc.org
Ruth
Natasha M
NM
German
April
A
Nelson
Shannen
S
Passo
Murray H
MH
Roebuck-Spencer
Tresa
T
Ying
Jun
J
Ris
Douglas
D
D000293:Adolescent; D000328:Adult; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008297:Male; D009483:Neuropsychological Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity