title: Reliable change in neuropsychological assessment of breast cancer survivors.
abstract: BACKGROUND
  The purpose of this study was to enhance the current understanding and interpretation of longitudinal change on tests of neurocognitive function in individuals with cancer. Scores on standard neuropsychological instruments may be impacted by practice effects and other random forms of error.
  
  
  METHODS
  The current study assessed the test-retest reliability of several tests and overarching cognitive domains comprising a neurocognitive battery typical of those used for research and clinical evaluation using relevant time frames. Practice effect-adjusted reliable change confidence intervals for test-retest difference scores based on a sample of patient-matched healthy controls are provided.
  
  
  RESULTS
  By applying reliable change confidence intervals to scores from two samples of breast cancer patients at post-treatment follow-up assessment, meaningful levels of detectable change in cognitive functioning in breast cancer survivors were ascertained and indicate that standardized neuropsychological instruments may be subject to limitations in detection of subtle cognitive dysfunction over clinically relevant intervals, especially in patient samples with average to above average range baseline functioning.
  
  
  CONCLUSIONS
  These results are discussed in relation to reported prevalence of cognitive change in breast cancer patients along with recommendations for study designs that enhance detection of treatment effects.
authors: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors: Charissa
authors: C
authors: Andreotti
authors: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors: James C
authors: JC
authors: Root
authors: Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors: Sanne B
authors: SB
authors: Schagen
authors: Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors: Brenna C
authors: BC
authors: McDonald
authors: Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors: Andrew J
authors: AJ
authors: Saykin
authors: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors: Thomas M
authors: TM
authors: Atkinson
authors: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors: Yuelin
authors: Y
authors: Li
authors: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors: Tim A
authors: TA
authors: Ahles
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: breast cancer; cognition; neuropsychological assessment; survivorship