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Titolo:
Cognitive performance after cardiac operation: Implications of regression toward the mean
Autore:
Browne, SM; Halligan, PW; Wade, DT; Taggart, DP;
Indirizzi:
Rivermead Rehabil Ctr, Dept Expt Psychol, Oxford OX1 4XD, England Rivermead Rehabil Ctr Oxford England OX1 4XD ol, Oxford OX1 4XD, England John Radcliffe Hosp, Oxford Heart Ctr, Headington, England John Radcliffe Hosp Headington England d Heart Ctr, Headington, England
Titolo Testata:
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
fascicolo: 3, volume: 117, anno: 1999,
pagine: 481 - 485
SICI:
0022-5223(199903)117:3<481:CPACOI>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY BYPASS; CARDIOPULMONARY BYPASS; SURGERY; DYSFUNCTION; STATEMENT; CONSENSUS; TESTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Halligan, PW Rivermeadandhabil Ctr, Dept Expt Psychol, Abingdon Rd, OxfordOX1 4XD, Engl Rivermead Rehabil Ctr Abingdon Rd Oxford England OX1 4XD ngl
Citazione:
S.M. Browne et al., "Cognitive performance after cardiac operation: Implications of regression toward the mean", J THOR SURG, 117(3), 1999, pp. 481-485

Abstract

Objective: The purpose of this study was to assess the influence of regression toward the mean on different definitions of cognitive dysfunction after coronary artery bypass graft operation. Methods: A total of 120 patients who underwent nonemergency coronary bypass operation and who were involved in a randomized trial of an anti-inflammatory agent were assessed prospectively with a battery of 10 psychometric tests covering a variety of cognitive domains. The battery was administered before the operation and 5 days and3 months after the operation. Data from 2 representative tests, the Rey Auditory Verbal Learning Test and the Trail Making Test (part A), were used. The influence of regression toward the mean on 3 commonly used single-case definitions of cognitive impairment (1 SD method; one-half SD method; 20% method) was analyzed. Results: Group mean performance deteriorated on the Rey Auditory Verbal Learning Test at the discharge assessment (P <.001) and remained below baseline at 3 months (P =.03), Mean performance on the Trail Making Test (part A) showed a near-significant decline at discharge (P =.06), followed by improvement at 3 months (P <.01). Regression toward the meanwas demonstrated on both tests by classifying the preoperative scores intolow moderate, and high-performance categories. Applying the different definitions of dysfunction resulted in substantially larger numbers of patientsin the high-performance group being classified as impaired. Conclusion: Single-case definitions of cognitive dysfunction are influenced strongly by regression toward the mean. Disproportionate numbers of high-baseline performers are classified as impaired, thereby questioning the validity of established definitions. Group mean analysis with controls is potentially the most reliable method for detecting real change or differences.

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Documento generato il 19/01/20 alle ore 14:28:34