Here you can find my current projects, where I am leading author, all are open access, or otherwise stated. Hyperlinks take you direct to pre-prints, publications, and data repositories.
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This project is in collaboration with multiple national sites across
the UK, including Dr Eugene Tang and Dr Nele Demeyere. Currently I am
collecting some initial data to support the use of the OCS-GP. We are
preparing funding applications for this project currently. Copyright is
retained for all uses of the OCS-GP, and OCS-GP name.
- Status: Under active recruitment (January 2024)
This project, in collaboration with Dr Suzanne Burns (the creator of
the MET-Home), will generate new
data for the MET-Home in healthy adults and stroke survivors with the
aim of generating new normative cut offs for use in clinical practice.
Currently there are no standardised norms for this task, yet we know,
with anecdotal evidence, that it is being used in clinical practice
regularly.
- Status: In preparation (January 2024).
Assessment of mental capacity is a critical aspect of clinical practice. Mental capacity is a legal concept defined in statute by the Mental Capacity Act 2005 (England and Wales). Current best practice consists of a qualitative interview to elucidate the ability to (i) understand, (ii) retain and (iii) weigh up the specific information at hand, and to (iv) communicate a decision. Capacity assessments often fail to align with the legal standards and are often contentious with low agreement rates. We developed and validated a new brief neuropsychological screening tool (The Oxford Competency Assessment; COMPASS) to assess the cognitive constructs aligned to the core abilities required for mental capacity. We aim for COMPASS to help decide best practice for conducting a full mental capacity assessment in light of identified issues. That is, if a memory impairment is found, clinicians know to adapt procedures to reduce uneccessary burden on retention of information during the capacity assessment.
122 neurologically healthy participants were compared with 117 participants with neurological conditions (stroke or dementia/mild cognitive impairment) on COMPASS performance. The validation included 56 control participants and 69 neurological participants who completed additional neuropsychological tasks including the MoCA. 29 participants were re-tested. 80 participants were compared against a mental capacity assessment on setting up a hypothetical Lasting Power of Attorney.
We found great reliability of the COMPASS, convergent validity analysis revealed low but significant correlations, and divergent validation was achieved. The COMPASS total score was similar to the MoCA in identifying impairment in mental capacity assessments, but neither were adequate to differentiate impairment in core abilities (i.e., understanding, retention, or weighing up).
Further research comparing the COMPASS to capacity assessments with
differing complexity is necessary, as it may be that the decision
focussed on was too complex for an initial investigation.
- Status: In preparation