Acceptability and feasibility of cognitive assessments with adults with primary brain cancer and brain metastasis: A systematic review

Melissa A Carlson; Elizabeth A Fradgley; Della Yates; Sarah Morris; Jordan Tait; Christine L Paul

doi:10.1093/nop/npac097

Acceptability and feasibility of cognitive assessments with adults with primary brain cancer and brain metastasis: A systematic review

Neurooncol Pract. 2022 Dec 26;10(3):219-237. doi: 10.1093/nop/npac097. eCollection 2023 Jun.

Authors

Melissa A Carlson¹, Elizabeth A Fradgley¹, Della Yates¹, Sarah Morris¹, Jordan Tait², Christine L Paul¹

Affiliations

¹ School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia.
² GP Synergy, NSW & ACT Research and Evaluation Unit, Level 1, 20 McIntosh Dr, Mayfield West, NSW 2304, Australia.

Abstract

Routine cognitive assessment for adults with brain cancers is seldom completed but vital for guiding daily living, maintaining quality of life, or supporting patients and families. This study aims to identify cognitive assessments which are pragmatic and acceptable for use in clinical settings. MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane were searched to identify studies published in English between 1990 and 2021. Publications were independently screened by two coders and included if they: (1) were peer-reviewed; (2) reported original data relating to adult primary brain tumor or brain metastases; (3) used objective or subjective assessments; (4) reported assessment acceptability or feasibility. The Psychometric And Pragmatic Evidence Rating Scale was used. Consent, assessment commencement and completion, and study completion were extracted along with author-reported acceptability and feasibility data. PROSPERO Registration: CRD42021234794. Across 27 studies, 21 cognitive assessments had been assessed for feasibility and acceptability; 15 were objective assessments. Acceptability data were limited and heterogeneous, particularly consent (not reported in 23 studies), assessment commencement (not reported in 19 studies), and assessment completion (not reported in 21 studies). Reasons for non-completion could be grouped into patient-factors, assessment-factors, clinician-factors, and system-factors. The three cognitive assessments with the most acceptability and feasibility data reported were the MMSE, MoCA, and NIHTB-CB. Further acceptability and feasibility data are needed including consent, commencement and completion rates. Cost, length, time, and assessor burden are needed for the MMSE, MoCA, and NIHTB-CB, along with potentially new computerized assessments suited for busy clinical settings.

Keywords: acceptability; brain cancer; cognition; cognitive assessment; easibility.

Publication types

Review