The Cognitive Assessment Interview (CAI): Development and validation of an empirically derived, brief interview-based measure of cognition

Semel Institute for Neuroscience & Human Behavior, Geffen School of Medicine at UCLA, United States.
Schizophrenia Research (Impact Factor: 3.92). 08/2010; 121(1-3):24-31. DOI: 10.1016/j.schres.2010.04.016
Source: PubMed


Practical, reliable "real world" measures of cognition are needed to supplement neurocognitive performance data to evaluate possible efficacy of new drugs targeting cognitive deficits associated with schizophrenia. Because interview-based measures of cognition offer one possible approach, data from the MATRICS initiative (n=176) were used to examine the psychometric properties of the Schizophrenia Cognition Rating Scale (SCoRS) and the Clinical Global Impression of Cognition in Schizophrenia (CGI-CogS).
We used classical test theory methods and item response theory to derive the 10-item Cognitive Assessment Interview (CAI) from the SCoRS and CGI-CogS ("parent instruments"). Sources of information for CAI ratings included the patient and an informant. Validity analyses examined the relationship between the CAI and objective measures of cognitive functioning, intermediate measures of cognition, and functional outcome.
The rater's score from the newly derived CAI (10 items) correlate highly (r=.87) with those from the combined set of the SCoRS and CGI-CogS (41 items). Both the patient (r=.82) and the informant (r=.95) data were highly correlated with the rater's score. The CAI was modestly correlated with objectively measured neurocognition (r=-.32), functional capacity (r=-.44), and functional outcome (r=-.32), which was comparable to the parent instruments.
The CAI allows for expert judgment in evaluating a patient's cognitive functioning and was modestly correlated with neurocognitive functioning, functional capacity, and functional outcome. The CAI is a brief, repeatable, and potentially valuable tool for rating cognition in schizophrenia patients who are participating in clinical trials.

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    • "sensitivity to the severity of neurocognitive deficits. These results confirm in an independent sample the relationship of the CAI ratings with objectively measured cognition (MCCB), functional capacity (UPSA), and role functioning (RFS) that we demonstrated in two prior samples (Ventura et al., 2013; Ventura et al., 2010b). We also expand these relationships to first episode patients. "
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    ABSTRACT: Background: Progress has been made in developing interview-based measures for the assessment of cognitive functioning, such as the Cognitive Assessment Interview (CAI), as co-primary measures that compliment objective neurocognitive assessments and daily functioning. However, a few questions remain, including whether the relationships with objective cognitive measures and daily functioning are high enough to justify the CAI as an co-primary measure and whether patient-only assessments are valid. Methods: Participants were first-episode schizophrenia patients (n=60) and demographically-similar healthy controls (n=35), chronic schizophrenia patients (n=38) and demographically similar healthy controls (n=19). Participants were assessed at baseline with an interview-based measure of cognitive functioning (CAI), a test of objective cognitive functioning, functional capacity, and role functioning at baseline, and in the first episode patients again 6months later (n=28). Results: CAI ratings were correlated with objective cognitive functioning, functional capacity, and functional outcomes in first-episode schizophrenia patients at similar magnitudes as in chronic patients. Comparisons of first-episode and chronic patients with healthy controls indicated that the CAI sensitively detected deficits in schizophrenia. The relationship of CAI Patient-Only ratings with objective cognitive functioning, functional capacity, and daily functioning were comparable to CAI Rater scores that included informant information. Conclusions: These results confirm in an independent sample the relationship of the CAI ratings with objectively measured cognition, functional capacity, and role functioning. Comparison of schizophrenia patients with healthy controls further validates the CAI as an co-primary measure of cognitive deficits. Also, CAI change scores were strongly related to objective cognitive change indicating sensitivity to change.
    Full-text · Article · Feb 2016 · Schizophrenia Research
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    • "For example, the MATRICS Consensus Cognitive Battery (MCCB) uses the " Neuropsychological Assessment Battery Mazes " task to assess the Reasoning and Problem-solving domains, which may represent a more valid measure. Moreover, newer and potentially more robust measures of subjective appraisals of cognitive functioning are also available (e.g., Cognitive Assessment Interview, Ventura et al., 2010, 2013), which future studies should incorporate. Similarly, while the ACR questionnaire represents an initial attempt to gauge opinions regarding the treatment of cognitive symptoms, its validity and reliability remain questionable. "
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