Dataset Information

Examining the Association between Patient-Reported Symptoms of Attention and Memory Dysfunction with Objective Cognitive Performance: A Latent Regression Rasch Model Approach.

ABSTRACT:

Objective

Patient-reported cognition generally exhibits poor concordance with objectively assessed cognitive performance. In this article, we introduce latent regression Rasch modeling and provide a step-by-step tutorial for applying Rasch methods as an alternative to traditional correlation to better clarify the relationship of self-report and objective cognitive performance. An example analysis using these methods is also included.

Method

Introduction to latent regression Rasch modeling is provided together with a tutorial on implementing it using the JAGS programming language for the Bayesian posterior parameter estimates. In an example analysis, data from a longitudinal neurocognitive outcomes study of 132 breast cancer patients and 45 non-cancer matched controls that included self-report and objective performance measures pre- and post-treatment were analyzed using both conventional and latent regression Rasch model approaches.

Results

Consistent with previous research, conventional analysis and correlations between neurocognitive decline and self-reported problems were generally near zero. In contrast, application of latent regression Rasch modeling found statistically reliable associations between objective attention and processing speed measures with self-reported Attention and Memory scores.

Conclusions

Latent regression Rasch modeling, together with correlation of specific self-reported cognitive domains with neurocognitive measures, helps to clarify the relationship of self-report with objective performance. While the majority of patients attribute their cognitive difficulties to memory decline, the Rash modeling suggests the importance of processing speed and initial learning. To encourage the use of this method, a step-by-step guide and programming language for implementation is provided. Implications of this method in cognitive outcomes research are discussed.

SUBMITTER: Li Y

PROVIDER: S-EPMC4876936 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundAssessing subjective social status (SSS) may be easily accommodated in the context of a Health and Demographic Surveillance System (HDSS). To our knowledge, no prior studies have examined the association of SSS and health in Angola. Subjective socioeconomic measures may provide a rapid assessment of a relevant social status construct, important for studying health inequalities. In this study, we addressed social determinants of health by examining the relationship between the subjective and objective social status, reported health and healthcare-seeking behaviour.MethodsThis research results from a cross-sectional study performed during 2015 in the Dande HDSS, in Angola. We tested the application of the MacArthur scale as a measure of SSS in a developing setting, in a sample of 12,246 households. First, we investigated its relation to objective socioeconomic indicators, and then we explored how subjective and objective social status associate with health reported needs and health-seeking behaviour of the surveyed population. Chi-square, ANOVA tests, and Receiver Operating Characteristics (ROC) Curves analysis were computed for testing relationships between subjective status ladder quartiles, sociodemographic and household characteristics. Logistic regression was used to examine the influence of subjective perception of status in self-reported health and health-seeking behaviour.ResultsOur findings suggest that the SSS follows a gradient distribution obtained with more objective socioeconomic indicators. Additionally, we found that subjective perception of status influence health needs reporting and health-seeking behaviour and its significant effect remained after controlling for the objective socioeconomic markers. Individuals standing in the second quartile of the social ladder have more odds of reporting illness and those in the highest quartiles of the ladder were twice more likely (OR = 2.23, 95% CI = 1.52-3.26) to seek help from formal health services than those at the bottom of the ladder.ConclusionsThe MacArthur Scale is a valuable tool to measure SSS in the Dande HDSS, relevant for studying socioeconomic disparities and health inequalities. It is also an easier alternative to traditional measures such as income, usually difficult to measure in developing settings. The social perception of status should be considered as a complement with objective indicators when exploring social determinants of health.