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.

项目摘要 根据来自大型联盟研究的估计，与HIV相关的神经认知障碍（Hand） 一次影响22-84％的感染者。绝大多数手动诊断很温和， 在最新的研究诊断标准中，被称为非对称神经认知障碍（ANI）。 根据《宪章研究》的数据，多达70％的被诊断为手的人患有ANI。然而 有人认为ANI过度诊断，这是一个事实，即诊断标准被应用于其他 健康，未感染的个体，假阳性诊断率很高。另一个可能的原因 高估ANI的普遍性是次优的努力。也就是，参加研究的个人 得出患病率可能不会在神经认知测试上付出足够的精力，从而膨胀 轻度手患病率的估计。来自多中心艾滋病队列研究（MAC）的初步数据， 最大的HIV研究纳入了神经认知措施，表明超过50％的MAC参与者 最近完成的综合神经认知测试报告了次优的努力。最常见的原因 疲倦/疲倦，集中/分心不足，“其他”。此外，还有一个顺序 努力水平和手部严重程度之间的关系，表明那些努力最差的人的关系最高 ANI诊断率。初步数据还允许识别次优努力的预测指标， 包括低教育和失业。这些初步发现对未来极为重要 手研究。他们不仅认为，由于研究中的努力不佳，手率膨胀了 参与者，但也有特定的原因和预测次优的努力的原因，可以是 解决。在拟议的研究中，我们将进一步探索MAC中的次优努力。结果可能导致 进行手动患病率估计和建立优化研究精力的方法。