Diagnostic Validation of the Computerised Extrapersonal Neglect Test (CENT) in Stroke Survivors

Stermsek, Petar (2024) Diagnostic Validation of the Computerised Extrapersonal Neglect Test (CENT) in Stroke Survivors. Doctoral thesis, University of East Anglia.

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Abstract

Background: Spatial neglect is a syndrome commonly experienced by stroke survivors and associated with range of difficulties including higher risk of falls and longer lengths of hospital stay. Most neuropsychological tests for spatial neglect are primarily focused in the peripersonal space (within arm’s reach), resulting in the potential underdiagnosis of extrapersonal neglect (beyond arm’s reach).

Aim: This thesis aimed to investigate the currently available tests for extrapersonal spatial neglect with established psychometric properties before exploring the psychometric properties of the novel Computerised Extrapersonal Neglect Test (CENT).

Methods: For the systematic review, 2522 studies were screened for eligibility. The remaining studies were critically appraised using the Quality Assessment of Validity Studies (QAVALS) tool. A narrative synthesis approach was then utilised to systematically analyse the findings of the selected studies. A cross-sectional diagnostic validation study was then completed within stroke-survivor’s homes to explore the psychometric properties of the CENT.

Results: The systematic review identified 22 validation studies, revealing limitations in reported psychometric properties and methodological rigor, highlighting the need for more robust validation studies and the further development of diagnostic tools for extrapersonal spatial neglect. The diagnostic validation study that followed, demonstrated that the CENT, particularly the CENT cancellation task, had excellent diagnostic accuracy, and high concurrent validity, ecological validity, internal consistency, and discriminant validity. Notably, 11% of stroke-survivors were identified as having extrapersonal spatial neglect only.

Conclusions: Currently available validation studies for diagnostic tests for extrapersonal spatial neglect vary substantially in their quality and reported psychometric properties. The diagnostic validation study presented in this thesis suggests that the CENT has promising psychometric properties. Moreover, this study underscores the importance of formal extrapersonal spatial neglect testing, as potentially one in ten stroke survivors may be being overlooked without proper diagnosis.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Chris White
Date Deposited:	07 Nov 2024 09:35
Last Modified:	07 Nov 2024 09:35
URI:	https://ueaeprints.uea.ac.uk/id/eprint/97552
DOI:

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