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Advanced Neurology Cognitive assessment using performance-based tests

Table 1. Example of search strategy for PubMed
Search strategy Search terms
#4 (((“functional cognition” OR “everyday cognition” OR “cognitive capacities” OR “cognitive impairment” OR “cognitive
impairments” OR “cognitive deficits” OR “cognitive function”) OR “Cognition”[Mesh]) AND (“assessment” OR “observation” OR
“observational” OR “screening” OR “performance-based testing” OR “occupational therapy” OR “occupational therapists” OR
“activities of daily living” OR “ecological assessment”) AND (“Brain Injuries, Traumatic”[Mesh]) OR (“traumatic brain injury” OR
“TBI” OR “head injury”)))
#3 ((“functional cognition” OR “everyday cognition” OR “cognitive capacities” OR “cognitive impairment” OR “cognitive impairments”
OR “cognitive deficits” OR “cognitive function”) OR “Cognition”[Mesh])
#2 (“assessment” OR “observation” OR “observational” OR “screening” OR “performance-based testing” OR “occupational therapy”
OR “occupational therapists” OR “activities of daily living” OR “ecological assessment”)
#1 ((“Brain Injuries, Traumatic”[Mesh]) OR (“traumatic brain injury” OR “TBI” OR “head injury”))
Note: No limits applied.

Table 2. Inclusion and exclusion criteria for articles
Inclusion Exclusion
– Participants in the study to be aged 18 and over – Assessments for patients with progressive neurological conditions or mental illness
– Studies published in English – Questionnaires, carer reports, clinician reports, or self-reports
– Evidence of published studies of assessment use with adults – Assessments unable to be used by occupational therapists
who have experienced TBI – Global screening tests of cognition, for example, pencil-and-paper screening tests or
– Assessment able to be completed in an acute ward electronic versions of global screening tests
– Focus on performance-based testing of a real-life simulated – Assessments that need to be conducted in the home environment or community
ADL or IADL task to assess cognitive function setting, for example, requiring shops
– Assessment focused on functional cognition not isolated – ADL assessments where the focus is on ADL performance and not underlying
cognitive domains cognitive deficits contributing to performance
– Virtual-reality simulations of real-life ADLs or IADLs
Abbreviations: TBI: Traumatic brain injury; ADL: Activities of daily living; IADL: Instrumental activities of daily living.
groupings were identified based on the composition of the hand-searching. After the removal of duplicates, articles
assessments: Those that were a single prescribed task; those were screened by title and abstract by the first author.
with multiple prescribed tasks; and those that consisted Where the application of the criteria was unclear, discussion
of a variable number of tasks, where the assessment was between the first and second authors occurred until an
individualized. Assessments were categorized according agreement was reached. Of the 120 articles selected for
to their level of complexity and focused on either ADL or full-text review, 91 were excluded due to various reasons;
IADL tasks or both. Data were organized into tables, and for exmaple, if the study focused on PADLs only without
assessments were documented against applicability criteria, reference to cognitive function, used global rehabilitation
underlying approach/model, cognitive domains addressed, outcome measures, required access to a patient’s own
and methodological and reporting quality of studies home/community shops, or involved tests completed in
(QuADS). The QuADS tool consists of 13 criteria, with a virtual reality. A total of 18 assessments (reported across
possible rating score of 0 – 3 for each and a maximum total 29 articles) were retained for analysis in this review. The
score of 39. Criteria of the QuADS include whether the preferred reporting items for systematic reviews and meta-
study includes a discussion of theories and concepts that analyses flow diagram is displayed in Figure 1.
underpin the research, whether sampling was appropriate
to achieve the aims of the study, and whether research The final 18 assessments included in the review are
strengths and limitations were critically discussed. Criteria summarized in Table 3, which also features the original
are not weighted, and summary scores do not indicate a article for the assessment and key articles where the
high or low quality of an individual study; instead, they assessment was used relevant to patients with TBI.
serve to encourage discussion about the quality of reporting Summarizing the assessments in this format identified wide
of individual studies, in relation to the scoping review. variation in assessments, cognitive domains, and underlying
18
approaches. Among the 18 assessments included in this
4. Results review, most were published by American authors.
The initial database search was conducted in August 2019 Regarding participant characteristics, of the 18
and supplemented by additional searches in May 2020 and included assessments, 12 had published studies where

Volume 4 Issue 1 (2025) 56 doi: 10.36922/an.4508