Initial Development and Evaluation of the Executive Function Performance Test–Enhanced (EFPT–E) in Women With Cancer-Related Cognitive Impairment

Abstract

Abstract Importance: Psychometrically sound instruments are needed to evaluate executive functioning in the population of people with cancer. Objective: To develop and evaluate the reliability and validity of the Executive Function Performance Test–Enhanced (EFPT–E) in women after being treated for breast cancer. Design: Cross-sectional. Setting: University research laboratory. Participants: Women treated for breast cancer who had cognitive impairment (n = 12) and community control participants (n = 13). Outcomes and Measures: Evaluators (n = 8) independently scored a recorded administration of the EFPT–E to evaluate interrater reliability. An assessment battery, including the EFPT–E, was administered to evaluate the EFPT–E’s known-groups validity and concurrent validity. Results: Excellent interrater reliability was observed for the EFPT–E total score and each subtask score (intraclass correlation coefficient = .90–.98). Moderate effect sizes were noted for the EFPT–E total score (Cohen’s d = 0.5) and the total number of cues (d = 0.4) between the breast cancer group and the control group, with the breast cancer group demonstrating poorer performance. A limited correlation was found between the EFPT–E and the other cognitive measures. Conclusions and Relevance: The results support the EFPT–E’s interrater reliability and warrant continued investigation to further establish its reliability and validity. What This Article Adds: Assessments are needed to quantify the impact of cognitive processes within functional tasks. The EFPT–E has been developed to assess the functional impact of mild cognitive impairment; initial testing with women with cancer showed excellent agreement between raters and promising results for validity.