A comparison of a novel neuropsychological screening tool with provider recommendations among pediatric cancer survivors.
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PURPOSE: We compared a novel parent-report screening tool developed by the Clinical Neuropsychology Collaborative for Childhood Cancers, referred to as the CNC3 Caregiver Report Questionnaire (CNC3-CRQ), against clinician recommendations for identifying childhood cancer survivors (CCS) needing referral to neuropsychology services. METHODS: The CNC3-CRQ was administered to parents of CCS seen at a pediatric oncology survivorship clinic, with positive scores indicating need for referral to neuropsychology. CNC3-CRQ results as a cumulative variable and by individual neurocognitive domain were compared with clinically derived recommendations for referral to neuropsychology by their survivorship provider. RESULTS: Among 173 participants, 41% had a history of hematologic malignancy and 20% had a history of central nervous system tumor. The CNC3-CRQ yielded recommendation for referral to neuropsychology for 68.2% of patients. Provider recommendations for referral to neuropsychology were significantly associated with higher odds of a positive CNC3-CRQ cumulative screen (OR = 13.2, 95% CI 3.76-52.1, p < 0.001). Across all neurocognitive domains, parent level of concern and symptom percentages were significantly positively associated with provider recommendations. When querying providers on their specific reasons for referral, reported parent/caregiver concern was significantly associated with a positive score in the CNC3-CRQ's Executive Functions: Behavior domain (OR 2.45, 95% CI 1.06-5.95, p < 0.05.) CONCLUSION: The CNC3-CRQ results had significantly positive convergent relationships with clinically derived recommendations by oncology providers specializing in CCS for referral to neuropsychology services. IMPLICATIONS FOR CANCER SURVIVORS: The CNC3-CRQ may serve as a structured decision-support tool within clinics caring for CCS and may be particularly useful for those with less experience identifying neurocognitive late effects.