Objective: Cognitive Estimation Tests (CETs) are used to assess decision-making. Previous versions include culturally- biased questions likely to disadvantage certain sections of the population. This study aimed to develop a new culture fair questionnaire and assess its reliability and validity.
Method: A 30-item questionnaire was developed and assessed for culture fairness. A normative range of answers was gathered, and a scale developed to define level of deviation from typical responses. Performance in a group of people with brain injury was compared to a matched group of healthy controls. Those with brain injury deemed able to make significant life decisions were compared with a group considered to lack this capacity, to determine whether this test may be useful when assessing decision-making capacity. Correlational analyses were conducted to determine whether there was a relationship between the test and performance on the Dysexecutive Questionnaire (DEX), a measure of everyday executive functioning. Test-retest reliability was examined with 30 of the normative sample.
Results: Results confirm previous literature showing that those with brain injury perform significantly worse than healthy controls. The test did not discriminate between patients with and without capacity to make important decisions, did not significantly correlate with the total score on the DEX and demonstrated relatively poor consistency. Conclusions: Based on these results, CETs do not appear to be reliable or valid enough for use in clinical assessments. A sub-set of the most sensitive items may prove useful, but further work is required to examine the reliability and validity of this item subset in new samples