title: The Childhood Cancer Survivor Study-Neurocognitive Questionnaire (CCSS-NCQ) revised: item response analysis and concurrent validity.
abstract: OBJECTIVE
  Childhood cancer survivors are at risk for neurocognitive impairment related to cancer diagnosis or treatment. This study refined and further validated the Childhood Cancer Survivor Study-Neurocognitive Questionnaire (CCSS-NCQ; Krull et al., 2008), a scale developed to screen for impairment in long-term survivors of childhood cancer.
  
  
  METHODS
  Items related to task efficiency, memory, organization, and emotional-regulation domains were examined using item response theory (IRT). Data were collected from 833 adult survivors of childhood cancer who completed self-report and direct neurocognitive testing for the St. Jude Lifetime Cohort Study. The revision process included: (a) content-validity mapping of items to domains, (b) constructing a revised CCSS-NCQ, (c) selecting items within specific domains using IRT, and (d) evaluating concordance between the revised CCSS-NCQ and direct neurocognitive assessment.
  
  
  RESULTS
  Using content and measurement properties, 32 items were retained (8 items in 4 domains). Items captured low to middle levels of neurocognitive concerns. The latent domain scores demonstrated poor convergent/divergent validity with the direct assessments. Adjusted ESs (ES; Cohen's d) for agreement between self-reported memory and direct memory assessment were moderate for total recall (ES = 0.66), long-term memory (ES = 0.63), and short-term memory (STM; ES = 0.55). ESs between self-rated task efficiency and direct assessment of attention were moderate for focused attention (ES = 0.70) and attention span (ES = 0.50), but small for sustained attention (ES = 0.36). Cranial radiation therapy and female gender were associated with lower self-reported neurocognitive function.
  
  
  CONCLUSIONS
  The revised CCSS-NCQ demonstrates adequate measurement properties for assessing day-to-day neurocognitive concerns in childhood cancer survivors, and adds useful information to direct assessment.
authors.affiliation: Department of Health Outcomes and Policy, College of Medicine, University of Florida.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Kenzik
authors.affiliation: Department of Health Outcomes Institute for Child Health Policy, College of Medicine, University of Florida.
authors.forename: I-Chan
authors.initials: IC
authors.lastname: Huang
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital.
authors.forename: Tara M
authors.initials: TM
authors.lastname: Brinkman
authors.affiliation: Department of Neuropsychology, Semmes Murphey Neurologic and Spine Institute.
authors.forename: Brandon
authors.initials: B
authors.lastname: Baughman
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital.
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.affiliation: Department of Health Outcomes and Policy, College of Medicine, University of Florida.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Shenkman
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D057567:Memory, Long-Term; D008570:Memory, Short-Term; D011939:Mental Recall; D009369:Neoplasms / Q000523:psychology*; D015203:Reproducibility of Results; D057566:Self Report; D017741:Survivors / Q000523:psychology*