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Cognitive Predictors of Reasoning through Treatment Decisions in Patients with Newly Diagnosed Brain Metastases

Published online by Cambridge University Press:  01 July 2015

Adam Gerstenecker ,
Kevin Duff ,
Karen Meneses ,
John B. Fiveash ,
Louis B. Nabors  and
Kristen L. Triebel
Adam Gerstenecker
Affiliation:
Department of Neurology, Division of Neuropsychology, UAB, Birmingham, Alabama
Kevin Duff
Affiliation:
Department of Neurology, University of Utah, Salt Lake City, Utah
Karen Meneses
Affiliation:
Comprehensive Cancer Center, UAB, Birmingham, Alabama School of Nursing, UAB, Birmingham, Alabama
John B. Fiveash
Affiliation:
Comprehensive Cancer Center, UAB, Birmingham, Alabama Department of Radiation Oncology, UAB, Birmingham, Alabama
Louis B. Nabors
Affiliation:
Comprehensive Cancer Center, UAB, Birmingham, Alabama Department of Neurology, Division of Neuro-oncology, UAB, Birmingham, Alabama
Kristen L. Triebel*
Affiliation:
Department of Neurology, Division of Neuropsychology, UAB, Birmingham, Alabama Comprehensive Cancer Center, UAB, Birmingham, Alabama
*
Correspondence and reprint requests to: Kristen L. Triebel, Department of Neurology, University of Alabama at Birmingham, Sparks Center 650, 1720 7th Avenue South, Birmingham, AL 35294-0017. E-mail: [email protected]
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Abstract

To examine the association between reasoning through medical treatment decisions and cognition in a sample of patients with brain metastasis. The association between reasoning and cognition was examined using data from 41 patients with diagnosed brain metastasis. All diagnoses were made by a board-certified radiation oncologist and were verified histologically. In total, 41 demographically matched, cognitively healthy controls were also included to aid in classifying patients with brain metastasis according to reasoning status (i.e., intact or impaired). Results indicate that measures of episodic memory and processing speed were associated with reasoning. Using these two predictors, actuarial equations were constructed that can be used to help screen for impaired reasoning ability in patients’ with brain metastasis. The equations presented in this study have clinical significance as they can be used to help identify patients at risk for possessing a diminished ability to reason through medical treatment decisions and, thus, are in need of a more comprehensive evaluation of their medical decision-making capacity. (JINS, 2015, 21, 412–418)

Keywords

Medical decision-makingCognitionMalignant brain tumorMedical ethicsMemoryVerbal fluency
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 21 , Issue 6 , July 2015 , pp. 412 - 418
Copyright
Copyright © The International Neuropsychological Society 2015 

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References

Altman, D.G., & Bland, J.M. (1994). Diagnostic tests 3: Receiver operating characteristic plots. BMJ (Clinical Research Ed.), 309(6948), 188–188.Google Scholar
Appelbaum, P.S., & Grisso, T. (1988). Assessing patients' capacities to consent to treatment. The New England Journal of Medicine, 319(25), 1635–1638.Google Scholar
Beck, A.T., Steer, R.A., & Brown, G. (1996). Manual for the Beck Depression Inventory – II. San Antonio, TX: Psychological Corporation.Google Scholar
Brandt, J. B. R. (2001). Hopkins Verbal Learning Test-Revised: Professional Manual. Florida: PAR.Google Scholar
Dreer, L.E., Devivo, M.J., Novack, T.A., Krzywanski, S., & Marson, D.C. (2008). Cognitive predictors of medical decision-making capacity in traumatic brain injury. Rehabilitation Psychology, 53(4), 486–497.Google Scholar
Dymek, M.P., Marson, D., & Harrell, L. (1999). Factor structure of capacity to consent to medical treatment in patients with Alzheimer's disease. Journal of Forensic Neuropsychology, 1, 27–48.Google Scholar
Gerstenecker, A., Meneses, K., Duff, K., Fiveash, J., Marson, D., & Triebel, K.L. (2015). Cognitive predictors of understanding treatment decisions in patients with newly diagnosed brain metastases. Cancer 121, 2013–2019.CrossRefGoogle Scholar
Karnofsky, D.A. & Burchenal, J.A. (1949). The clinical evaluation of chemotherapeutic agents in cancer. In: C. M. MacLeod (Ed.), Evaluation of Chemotherapeutic Agents (199--205). New York: Columbia University Press.Google Scholar
Marson, D., & Ingram, K.K. (1996). Competency to consent to treatment: A growing field of research: Commentary. Journal of Ethics, Law, and Aging, 2(2), 59–63.Google ScholarPubMed
Marson, D.C., Ingram, K.K., Cody, H.A., & Harrell, L.E. (1995). Assessing the competency of patients with Alzheimer's disease under different legal standards. A prototype instrument. Archives of Neurology, 52(10), 949–954.Google Scholar
Martin, R.C., Okonkwo, O.C., Hill, J., Griffith, H.R., Triebel, K., Bartolucci, A., & Marson, D.C. (2008). Medical decision-making capacity in cognitively impaired Parkinson’s disease patients without dementia. Movement Disorders, 23(13), 1867–1874. doi: 10.1002/mds.22170 CrossRefGoogle ScholarPubMed
Okonkwo, O., Griffith, H.R., Belue, K., Lanza, S., Zamrini, E.Y., Harrell, L.E., & Marson, D.C. (2007). Medical decision-making capacity in patients with mild cognitive impairment. Neurology, 69(15), 1528–1535.CrossRefGoogle ScholarPubMed
Okonkwo, O.C., Griffith, H.R., Belue, K., Lanza, S., Zamrini, E.Y., Harrell, L.E., & Marson, D.C. (2008). Cognitive models of medical decision-making capacity in patients with mild cognitive impairment. Journal of the International Neuropsychological Society, 14(2), 297–308.Google Scholar
Platta, C.S., Khuntia, D., Mehta, M.P., & Suh, J.H. (2010). Current treatment strategies for brain metastasis and complications from therapeutic techniques: A review of current literature. American Journal of Clinical Oncology, 33(4), 398–407.Google Scholar
Posner, J.B. (1995). Neurologic complication of cancer. Philadelphia, PA: F.A. Davis Company.Google Scholar
Reitan, R.M., & Wolfson, D. (1993). The Halstead-Reitan neuropsycholgical test battery: Theory and clinical interpreation. South Tucson, AZ: Neuropsychology Press.Google Scholar
Ruff, R.M., Light, R.H., Parker, S.B., & Levin, H.S. (1996). Benton Controlled Oral Word Association Test: Reliability and updated norms. Archives of Clinical Neuropsychology, 11(4), 329–338.Google Scholar
Shaw, E., Scott, C., Souhami, L., Dinapoli, R., Kline, R., Loeffler, J., & Farnan, N. (2000). Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: Final report of RTOG protocol 90-05. International Journal of Radiation Oncology, Biology, and Physics, 47(2), 291–298.CrossRefGoogle ScholarPubMed
Triebel, K.L., Gerstenecker, A., Marson, D., Fiveash, J.B., Meneses, K., Meyers, C.A., & Nabors, L.B. (epub ahead of print). Capacity of patients with brain metastasis to make treatment decisions. Psychooncology, doi: 10.1002/pon.3753 CrossRefGoogle Scholar
Triebel, K.L., Martin, R.C., Nabors, L.B., & Marson, D.C. (2009). Medical decision-making capacity in patients with malignant glioma. Neurology, 73(24), 2086–2092. doi: 10.1212/WNL.0b013e3181c67bce CrossRefGoogle ScholarPubMed
Wechsler, D.A. (1997). Wechsler Adult Intelligence Scale (3rd ed.). San Antonio, TX: The Psychological Corporation.Google Scholar
Wilkinson, G.S. (1993). The Wide Range Achievement Test. Manual 3rd ed., Wilmington, DE: Wide Range.Google Scholar