The PRECIS instrument aims to bridge the gap in understanding cognitive impairment in schizophrenia from the patient’s perspective. Traditional measures have relied heavily on performance-based outcomes, neglecting the subjective experiences of patients. This study focuses on validating the PRECIS instrument, which allows patients to directly report their cognitive challenges, offering a more holistic view of their daily struggles and the impact on their quality of life.
Study Design and Methodology
Researchers analyzed data from two major international clinical trials involving stable English-speaking patients with schizophrenia and a control group of 88 healthy individuals. The initial trial (n = 215) employed an exploratory factor analysis (EFA) of the original 35-item PRECIS to determine an optimal factor structure. This structure was further refined using item response theory (IRT) and tested through confirmatory factor analysis (CFA). The second trial (n = 410) served to validate and confirm these findings. Healthy controls were also assessed to evaluate additional statistical properties.
Key Findings
The EFA suggested a reduced 26-item model with six distinct factors: memory, communication, self-control, executive function, attention, and sharpness of thought. This model, supplemented by a 2-item bother score, was supported by IRT and demonstrated an excellent fit in the CFA, accounting for 69% of the variance. The PRECIS showed robust internal consistency and test-retest reliability. Comparisons between patients and healthy controls validated known-groups validity, and correlations with other cognitive and functioning instruments were moderate to weak, highlighting the unique insights provided by patient self-reports.
Concrete User Inferences
– The PRECIS instrument captures patient-reported cognitive impairments, offering a unique perspective not covered by performance-based measures.
– Six key cognitive domains are identified: memory, communication, self-control, executive function, attention, and sharpness of thought.
– The PRECIS shows strong internal consistency and test-retest reliability, indicating its reliability for repeated assessments.
– Moderate correlations with functional assessment tools suggest the PRECIS can complement existing measures for a comprehensive evaluation of cognitive impairment in schizophrenia.
This research provides substantial evidence supporting the reliability and validity of the PRECIS instrument. Unlike traditional performance-based measures, the PRECIS offers unique insights into the cognitive challenges faced by patients with schizophrenia from their own perspective, emphasizing the importance of including patient-reported outcomes in clinical assessments.
Original Article: J Patient Rep Outcomes. 2024 Jun 17;8(1):61. doi: 10.1186/s41687-024-00731-x.
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