Evaluating the suitability of the Perceive, Recall, Plan and Perform System of Task Analysis (PRPP-A) for assessing work-related cognitive difficulties in women after breast cancer: A comparison with Cambridge Neuropsychological Test Automated Battery (CANTAB).
Joanne Lewis, Lynette Mackenzie, Chris Chapparo and 1 others
PMID 42622509WHAT IT FOUND
In 12 women after breast cancer, a structured cognitive interview (PRPP-A) tracked with computerised neuropsychological tests and flagged attention and planning difficulties that were linked to reduced work.
Too small to change practice, but a starting point for OTs assessing work-related cognitive change.
Key findings
01All 12 women showed individual difficulties in applying cognitive strategies during work tasks, with the Plan quadrant (planning, sequencing, evaluating) having the lowest average scores; the weakest sub-scores were Continuing (47.08) and Initiating (56.92) on a 33-to-100 scale.
02Significant correlations were found between CANTAB and PRPP-A scores in three corresponding domains: attention (RVP–Attending, τ = 0.752, P = 0.002), memory (DMS–Facts, τ = 0.661, P = 0.008), and executive function (SWM–Programming, τ = −0.831, P < 0.001), suggesting the two tools measure overlapping constructs.
03PRPP-A Total Perceive (AUC = 0.969) and Total Plan (AUC = 0.734) showed predictive ability for women not returning to pre-cancer roles, but the authors note that with only 12 participants these estimates are unstable and should be interpreted with caution.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only 12 women, all with university degrees (five with master's), so the findings may not apply to women with lower educational attainment or different job types. The PRPP-A was administered by semi-structured interview rather than direct observation of work performance, which the authors acknowledge may reduce sensitivity to subtle cognitive difficulties. Cross-sectional design with no baseline cognitive testing, so no causal relationships between treatment and cognitive outcomes can be drawn. ROC analysis and correlations based on 12 participants produce unstable estimates with very wide uncertainty; the authors themselves flag this. The group was diverse in age at diagnosis (under 50 or over 50) and time since diagnosis (past 2 years to 15 years), adding variability in cognitive outcomes. No intervention was tested; the study only compared two assessment tools in the same people.
Declared interests
Authors declare no conflicts of interest. The study was funded by Cambridge Cognition (the company that produces CANTAB, one of the two tools being compared) and Occupational Therapy Australia.
The easy way to misread this
Do not read the AUC of 0.969 as strong evidence that the PRPP-A predicts which women will lose their job after breast cancer. It was calculated from 12 women, all with university degrees, and the authors themselves note the estimates are unstable. The significant correlations between the two tools were also based on 12 people, and a single correlation of τ = 0.831 in a sample this size could easily shift with a few more participants.