Causes and consequences of suboptimal cognitive effort in the MACS

MACS 中认知努力欠佳的原因和后果

• 批准号: 9789986
• 负责人: ANDREW J LEVINE
• 金额: $ 7.8万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9789986
• 关键词: Acculturation; Address; Affect; Alcohol or Other Drugs use; Anxiety; Area; Categories; Cognitive; Cohort Studies; Data; Diagnosis; Diagnostic; Diagnostics Research; Education; Enrollment; Failure; Fatigue; Future; HIV; HIV-associated neurocognitive disorder; Healthcare; Incentives; Individual; Investigation; Lead; Measures; Methods; NIH Office of AIDS Research; Neurocognitive; Neurocognitive Deficit; Neuropsychology; Pain; Paper; Participant; Performance; Population; Prevalence; Protocols documentation; Public Policy; Publishing; Reporting; Research; Research Priority; Resources; Severities; Source; Substance abuse problem; Supervision; Surveys; Testing; The Multicenter AIDS Cohort Study; Time; Training; Translations; Unemployment; Visit; Visual; analog; base; behavior observation; clinical practice; distraction; expectation; experience; improved; inattention; neglect; neurocognitive test; novel; performance tests; prospective; recruit; research study; sleep quality; university student

Project Summary Based on estimates derived from large consortium studies, HIV-associated neurocognitive disorders (HAND) affects between 22-84% of infected individuals at any one time. The vast majority of HAND diagnoses are mild, and are termed Asymptomatic Neurocognitive Impairment (ANI) in the most recent research diagnostic criteria. As many as 70% of those diagnosed with HAND have ANI, according to data from the CHARTER study. Yet some argue that ANI is over diagnosed, citing the fact that when the diagnostic criteria are applied to otherwise healthy, uninfected individuals, there is a very high rate of false-positive diagnoses. Another likely reason for the overestimated prevalence of ANI is suboptimal effort. That is, individuals enrolled in research studies from which prevalence rates are derived may not put forth sufficient effort on neurocognitive testing, thereby inflating estimates of mild HAND prevalence. Preliminary data from the Multicenter AIDS Cohort Study (MACS), the largest HIV study incorporating neurocognitive measures, indicates that over 50% of MACS participants who recently completed comprehensive neurocognitive testing reported suboptimal effort. The most common reasons being fatigued/tired, having poor concentration/distraction, and “other”. Furthermore, there was an ordinal relationship between effort level and HAND severity, indicating that those with the poorest effort have the highest rates of ANI diagnosis. The preliminary data also allowed for identification of predictors of suboptimal effort, including low education and unemployment. These preliminary findings are extremely important for the future study of HAND. They suggest not only that rates of HAND are inflated due to poor effort among research participants, but also that there are specific causes for, and predictors of, suboptimal effort that can be addressed. In the proposed study, we will further explore suboptimal effort in the MACS. The results may lead to adjustments in HAND prevalence estimates and establishing methods for optimizing effort in research studies.

项目概要 根据大型联合研究的估计，HIV 相关神经认知障碍 (HAND) 任何时候都会影响 22-84% 的感染者。绝大多数 HAND 诊断都是轻微的， 在最新的研究诊断标准中被称为无症状神经认知障碍（ANI）。 根据 CHARTER Yet 研究的数据，多达 70% 的 HAND 患者患有 ANI。 一些人认为 ANI 被过度诊断，理由是当诊断标准应用于其他情况时 健康、未感染的个体，假阳性诊断率非常高，这是造成这种情况的另一个可能原因。 高估 ANI 的患病率是次优的努力，也就是说，参加研究的个人。 得出的患病率可能没有在神经认知测试上投入足够的努力，从而趋于平缓 多中心艾滋病队列研究 (MACS) 的初步数据对轻度手足口病患病率的估计。 纳入神经认知测量的最大规模的 HIV 研究表明，超过 50% 的 MACS 参与者 最近完成的综合神经认知测试报告了最常见的原因。 疲劳/疲倦，注意力不集中/注意力不集中，以及“其他”此外，还有一个序数。 努力水平与 HAND 严重程度之间的关系，表明努力最差的人的努力程度最高 ANI 诊断率还可以识别次优努力的预测因素， 这些初步调查结果对于未来极为重要。 他们认为，HAND 的发生率之所以被夸大，不仅是因为研究工作不力。 参与者，但也有可能导致次优努力的具体原因和预测因素 在拟议的研究中，我们将进一步探讨 MACS 中的次优努力结果可能会导致。 调整 HAND 患病率估计并建立优化研究工作的方法。