Evidências de validade baseada na estrutura interna, sensibilidade e especificidade da escala Neuropsic-R
Evidências de validade da escala Neuropsic-R
Mots-clés :
neuropsicologia, testes neuropsicológicos, psicometria, validade.Résumé
Alterações neuropsicológicas são caracterizadas, principalmente, pelo comprometimento de funções como memória, atenção, funções executivas, habilidades viso-espaciais e linguagem, sejam adquiridas ou congênitas. O presente estudo examinou a estrutura interna e indicadores de sensibilidade e especificidade da escala Neuropsic-R. Participaram deste estudo 790 pacientes, sendo 432 (55%) hígidos (grupo controle) e 358 (45%) com provável acometimento neuropsicológico e neurológico (grupo clínico), de diferentes regiões brasileiras. Na análise exploratória, foi retido um fator, com cargas fatoriais entre 0,312 e 0,93. Os resultados da análise confirmatória revelaram que o modelo de um fator para 19 itens apresentou o melhor ajuste (RMSEA= 0,044; CFI =0,957; TLI = 0,953) e o índice de consistência interna geral do modelo foi de 0,93 (alfa de Cronbach). A sensibilidade e a especificidade, calculadas com base na curva ROC, revelou o escore mínimo de 43 pontos para a identificação de alterações neuropsicológicas (valores mínimos de 19 e máximo de 76 pontos), que distingue uma população presumivelmente doente da sadia. Para pacientes com suspeita de declínio cognitivo e demência, o ponto de corte se desloca para 47. Assim, a escala Neuropsic-R apresenta boa aplicabilidade, rápida e confiável, em diversos contextos, especialmente para fins clínicos e de pesquisa.
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