Preliminary study of the reliability and validity of the Johns Hopkins Adapted Cognitive Exam (Chinese version) in neurological intensive care unit patients

Objective: To evaluate the reliability and validity of the Chinese version of the Johns Hopkins Adapted Cognitive Exam (ACE) in neurological intensive care unit patients.Design: The English version of the ACE was translated and adapted into Chinese. The cognitive function of 40 critically ill NICU patients was assessed using the Chinese version of the ACE and the Mini-mental state examination (MMSE) battery. Scores on the ACE and MMSE were analyzed, and the scale’s content validity, construct validity, concurrent validity, internal consistency, inter-rater reliability, and test-retest reliability metrics were determined.Result: The coefficients for the Pearson correlations between individual item scores and total score ranged from 0.617 to 0.938, and content validity was good. ACE scores were significantly correlated with MMSE scores(r = 0.822, p<0.05). Five factors were extracted during the principal component analysis, the cumulative contribution of which was 85.90%. Overall, the factor loading of each item was 0.5, and the scale had good construct validity. The Chinese version of the ACE demonstrated good internal consistency (Cronbach’α = 0.756), inter-rater reliability (ICC>0.95), and test-retest reliability (ICC = 0.652–0.979).Conclusions: The results of this study suggest that the Chinese version of the ACE was a reliable and valid screening tool for cognitive impairment in NICU patients.List of abbreviations: ACE: (Johns Hopkins Adapted Cognitive Exam); NICU : (neurological intensive care unit); MMSE: (Mini-Mental State Examination); SPSS: (the Statistical package for the Social Sciences); ICC: (Intra-class Correlation Coefficients); SCCM: (Society of Critical Care Medicine); PICS: (post–intensive care syndrome); ARDS:(acute respiratory distress syndrome); MoCA; (Montreal Cognitive Assessment); EFA: (exploratory factor analysis).