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Advanced Neurology Cognitive assessment using performance-based tests

to the evidence on assessments of psychometric strengths, 3.3. Stage 3: Selecting studies
clinical applicability is an important factor to consider Table 2 details the inclusion and exclusion criteria
when evaluating assessments and is especially relevant to developed by the research team. Quantitative, qualitative,
the acute care setting. and mixed methodology studies were eligible for inclusion.
3. Methods Conference abstracts, posters, and critical appraisal
articles were excluded from the study. Titles and abstracts
A scoping review was considered to be the most appropriate of articles were screened in the first instance by the first
choice to facilitate an overview of the variety of cognitive author. Articles were included if they: Focused on PBT,
assessments and associated concepts, describing existing used an occupation-based approach, were suitable for
research in the area and highlighting opportunities for use with adults with TBI, and were able to be completed
future research. This scoping review followed the five- within the physical constraints of an acute hospital ward.
stage guidelines outlined by Arksey and O’Malley : Following a discussion between the first and second
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(i) identifying the research question, (ii) identifying authors and a review against inclusion criteria, the full text
relevant studies, (iii) selecting studies, (iv) charting the of the studies was reviewed by the first author. Discussions
data, and (v) summarizing the results. Consideration of were conducted between the first and second authors with
the psychometric properties of each assessment was not full-text articles until a final agreement on the articles to
included in this review, as the aim was to conduct a broad be included was reached. Articles were included if the
overview of occupation-based assessments of cognition in assessments they documented were suitable for use with
acute care, PBTs, and pragmatic issues relevant to acute adults with TBI and were focused on PBT using real-life or
care. Reviews of the psychometric properties of cognitive simulated ADL or IADL tasks. Where it was unclear from
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assessments for patients with TBI, executive function, and the article whether an assessment was designed for use
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ABI, as well as performance-based assessments for older with patients with TBI, the author of the assessment was
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adults, have been conducted previously. Although ratings contacted for further information to determine eligibility.
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of methodological quality are not typically completed in
scoping reviews, we included a quality appraisal tool, 3.4. Stage 4: Charting the data
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the quality assessment with diverse studies (QuADS), as Data on descriptive characteristics of the assessments were
it allows for appraisal of a broad range of study designs extracted from the articles by the first author and included:
included in the scoping review. The purpose of the the name and origin of the assessment; a description of the
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QuADS tool is to offer supplementary information on the assessment task; characteristics of the participant sample;
evidence presented, prompting further discussion by the proportion of participants with TBI; cognitive domains
reader. assessed; and where documented, any underlying approaches
or models for each assessment. Assessments were charted
3.1. Stage 1: Identifying the research question
against fundamental pragmatic factors, which included the
Two main research questions were identified: (i) What availability of an assessment manual; cost and resources
cognitive assessments are available for occupational required; formal training required; and documented time
therapists to use in an acute care setting with patients who required to administer the assessment. The time required
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have had a TBI using performance-based approaches?; and to score an assessment and document the findings was
(ii) What are the characteristics of available performance- included, where published, by assessment authors. Data on
based tests in relation to clinical applicability for acute care descriptive characteristics were entered into a table by the first
settings? author and then checked by the second and third authors.
Descriptive characteristics included the methodological
3.2. Stage 2: Identifying relevant studies quality of the heterogeneous articles reporting on each of the

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A comprehensive search of the following databases was 18 assessments, using QuADS. Data on each assessment’s
initiated in September 2019, with no limits on date range potential clinical applicability for acute care was interpreted
imposed: PubMed, EMBASE, CINAHL, Cochrane Library, by the first author initially, then reviewed by the second
and PsycINFO. An example of the search strategy and and third authors, with final adjustments made through
search terms for PubMed is shown in Table 1. Manual discussion within the research team.
searching of reference lists from included articles was also
completed. The search strategy sought to identify research 3.5. Stage 5: Collating, summarizing, and reporting
articles and grey literature, including textbooks, reference results
books, and theses published in English. The search was Collated data were examined to identify commonalities
repeated in May 2020. and differences across assessments. Three assessment

Volume 4 Issue 1 (2025) 55 doi: 10.36922/an.4508