Development And Validation Of The Chinese (Putonghua) Version Of Oxford Cognitive Screen (OCS-Putonghua) For Post-Stroke Patients

Object:Developing the Chinese (Putonghua) version of the OCS (OCS-P) after translating and adapting the original OCS, and validate the OCS-P for use among post-stroke patients in China.Methods:After the authorization from the developer of OCS original version, we translated and localized the scale, and formatted a primary OCS-P. The content validity of the translated version OCS was evaluated by an expert panel, and determined the OCS-P by preliminary study.100 acute post-stroke patients and 200 healthy participants were recruited from Fujian University of Traditional Chinesemedicine Subsidiary Rehabilitation Hospital and located communities to examine content-validity, structural validity, substantive validity, concurrent validity, inter-rater reliability, test-retest reliability, and contrast-group discrimination of OCS-P. According to OCS-P scores of subjects, we examined its construct validity, substantive validity, concurrent validity, inter-rater reliability, test-retest reliability and internal consistency reliability, as well as the ability to distinguish cognitive differences between stroke and healthy people cognitive differences.Results:1. The OCS-P was confirmed by modifying 10 items of the Picture Naming, Orientation, Sentence Reading, and Delayed Recall and Recognition after content validity and preliminary study.2. The OCS-P showed satisfactory validities:The three-factor structure of OCS-P which was computed by explorative factor analysis explained 60.7% of the total variance; Substantive validity looks into the difficulty levels ranged from 0.59 to 0.97, and discriminative indices ranged from 0.09 to 0.65; The concurrent validity coefficient (Pearson’s correlation) for the total scores between the OCS-P and MoCA-BJ was 0.81 (P<0.001), ranged between 0.45 and 0.79 (P<0.001) at subscales level, while the concurrent validity coefficient for the scores on the Goldenberg’s test and the Praxis subscale of OCS-P was 0.72 (P<0.001).3. The OCS-P possessed good reliabilities:The inter-rater reliability coefficient (intraclass correlation coefficient, ICC) of the OCS-P total score was 0.90, and ranged from 0.74 to 0.99 at subscales level; The majority test-retest reliability coefficients were 0.68 for the total score and 0.54 to 0.95. Except for Visual Field and Space Asymmetry, post-stroke patients obtained significantly lower than the healthy older participants in almost all the subscales (P<0.005); Among the subtests, Picture Naming and Delayed Recall and Recognition-Verbal Recall were the largest differences between post-stroke patients and healthy older participants.Conclusion:1. The findings suggested that the OCS-P was a brief screening instrument for post-stroke cognitive impairment in Chinese.2. The good psychometric properties of OCS-P are important for clinical practitioners to identify and diagnose post-stroke patients with cognitive impairment.