title: Validation of the Pediatric Automated Neuropsychological Assessment Metrics in childhood-onset systemic lupus erythematosus.
abstract: OBJECTIVE
  To evaluate the reproducibility and validity of the Pediatric Automated Neuropsychological Assessment Metrics (Ped-ANAM) when used in childhood-onset systemic lupus erythematosus (cSLE).
  
  
  METHODS
  Forty children with cSLE and 40 matched controls were followed for up to 18 months. Formal neuropsychological testing at baseline was repeated after 18 months of followup; overall cognitive performance and domain-specific cognition (attention, working memory, processing speed, and visuoconstructional ability) were measured and categorized as normal cognition, mild/moderate, or moderate/severe impairment. The 10 Ped-ANAM subtests were completed every 6 months and twice at baseline. Ped-ANAM performance was based on accuracy (AC), mean time to correct response (MNc), throughput, and coefficient of variation of the time required for a correct response (CVc) as a measure of response consistency.
  
  
  RESULTS
  Particularly, MNc scores demonstrated moderate to substantial reproducibility (intraclass correlation coefficients 0.47-0.80). Means of select Ped-ANAM scores (MNc, AC, CVc) differed significantly between children with different levels of cognitive performance and allowed for the detection of moderate or severe cognitive impairment with 100% sensitivity and 86% specificity. Six Ped-ANAM subtests significantly correlated with the change in overall cognitive function in cSLE (baseline versus 18 months; Spearman's correlation coefficient >0.4, P < 0.05; n = 24).
  
  
  CONCLUSIONS
  The Ped-ANAM has moderate to substantial reproducibility, criterion and construct validity, and may be responsive to change in cSLE. Additional research is required to confirm the outstanding accuracy of the Ped-ANAM in identifying cognitive impairment, as well as its usefulness in detecting clinically relevant changes in cognition over time.
authors.affiliation: Cincinnati Children’s Hospital Medical Center, University of Cincinnati, William Rowe Division of Rheumatology, E 4010, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. hermine.brunner@cchmc.org
authors.forename: Hermine I
authors.initials: HI
authors.lastname: Brunner
authors.forename: Marisa S
authors.initials: MS
authors.lastname: Klein-Gitelman
authors.forename: Frank
authors.initials: F
authors.lastname: Zelko
authors.forename: Erin C
authors.initials: EC
authors.lastname: Thomas
authors.forename: Jessica
authors.initials: J
authors.lastname: Hummel
authors.forename: Shannen M
authors.initials: SM
authors.lastname: Nelson
authors.forename: Jennifer
authors.initials: J
authors.lastname: Huggins
authors.forename: Megan L
authors.initials: ML
authors.lastname: Curran
authors.forename: Tresa
authors.initials: T
authors.lastname: Roebuck-Spencer
authors.forename: Dean W
authors.initials: DW
authors.lastname: Beebe
authors.forename: Jun
authors.initials: J
authors.lastname: Ying
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards*; D011930:Reaction Time / Q000502:physiology