Approaching A Consensus Cognitive Battery For Clinical Trials In Schizophrenia: The Nimh-matrics Conference To Select Cognitive Domains And Test Criteria
Creator
Green M F; Nuechterlein K H; Gold J M; Barch D M; Cohen J; Essock S; Fenton W S; Frese F; Goldberg T E; Heaton R K; Keefe R S E; Kern R S; Kraemer H; Stover E; Weinberger D R; Zalcman S; Marder S R
Publisher
Biological Psychiatry
Date
2004
2004-09
Description
To stimulate the development of new drugs for the cognitive deficits of schizophrenia, the National Institute of Mental Health (NIMH) establisbed the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative. This article presents an overview of decisions from the first MATRICS consensus conference . The goals of the meeting were to 1) the cognitive domains that should be represented in a consensus cognitive battery and 2) prioritize key criteria, for selection of tests for the battery. Seven cognitive domains were selected based on a review of the literatum and input from experts: working memory, attention/vigilance, verbal learning and memory, visual learning and memory. Reasoning and problem solving, speed of processing, and social cognition. Based on discussions at this meeting, five criteria were considered essential for test selection: good test-retest reliability high utility as a repeated measure, relationship to functional outcome, potential response to pharmacologic agents, and practicality/tolerability. The results from this meeting constitute the initial steps for reaching a consensus cognitive battery for clinical trials in schizopbrenia.
Report on ISCTM Consensus Meeting on Clinical Assessment of Response to Treatment of Cognitive Impairment in Schizophrenia.
Creator
Keefe Richard S E; Haig George M; Marder Stephen R; Harvey Philip D; Dunayevich Eduardo; Medalia Alice; Davidson Michael; Lombardo Ilise; Bowie Christopher R; Buchanan Robert W; Bugarski-Kirola Dragana; Carpenter William T; Csernansky John T; Dago Pedro L; Durand Dante M; Frese Frederick J; Goff Donald C; Gold James M; Hooker Christine I; Kopelowicz Alex; Loebel Antony; McGurk Susan R; Opler Lewis A; Pinkham Amy E; Stern Robert G
Publisher
Schizophrenia bulletin
Date
2016
2016-01
Description
If treatments for cognitive impairment are to be utilized successfully, clinicians must be able to determine whether they are effective and which patients should receive them. In order to develop consensus on these issues, the International Society for CNS Clinical Trials and Methodology (ISCTM) held a meeting of experts on March 20, 2014, in Washington, DC. Consensus was reached on several important issues. Cognitive impairment and functional disability were viewed as equally important treatment targets. The group supported the notion that sufficient data are not available to exclude patients from available treatments on the basis of age, severity of cognitive impairment, severity of positive symptoms, or the potential to benefit functionally from treatment. The group reached consensus that cognitive remediation is likely to provide substantial benefits in combination with procognitive medications, although a substantial minority believed that medications can be administered without nonpharmacological therapy. There was little consensus on the best methods for assessing cognitive change in clinical practice. Some participants supported the view that performance-based measures are essential for measurement of cognitive change; others pointed to their cost and time requirements as evidence of impracticality. Interview-based measures of cognitive and functional change were viewed as more practical, but lacking validity without informant involvement or frequent contact from clinicians. The lack of consensus on assessment methods was viewed as attributable to differences in experience and education among key stakeholders and significant gaps in available empirical data. Research on the reliability, validity, sensitivity, and practicality of competing methods will facilitate consensus.
Subject
*Schizophrenic Psychology; Antipsychotic Agents/*therapeutic use; Cognition Disorders; Cognition Disorders/diagnosis/psychology/*therapy; cognitive assessment; Functional Assessment; Humans; Interviews; Neuropsychological Tests; neuropsychology; Nootropic Agents/*therapeutic use; Patient Selection; Psychiatric Rehabilitation/*methods; Research Instruments; Schizophrenia; Schizophrenia – Drug Therapy; Schizophrenia/diagnosis/*therapy; Severity of Illness Index; Surveys; treatment; United States Food and Drug Administration