# Performance of the Wisconsin Card Sorting Test in Oncopediatric Patients in an Oncology Unit in Cali, Colombia: A Cross-Sectional Observational Study

## TL;DR

This study evaluates the Wisconsin Card Sorting Test's performance in pediatric cancer patients in Colombia, finding it reliable for assessing executive functions.

## Contribution

The study provides empirical validation of the WCST's reliability in oncopediatric patients in a low- to middle-income setting.

## Key findings

- The WCST demonstrated reliable internal consistency (Cronbach’s α of 0.804) in assessing executive functions.
- Patients without brain deficits showed significantly better executive function performance (p = 0.002).
- No significant differences in executive functioning were found based on cancer type (p = 0.156).

## Abstract

Background: In 2020, the prevalence of cancer rose to 844,778 cases among the population aged 0–19 years. Approximately 90% of individuals under 18 years of age reside in low- and middle-income countries, where cancer survivors report adverse outcomes that negatively impact their general health, emotional state, and external factors such as academic performance due to the effect of these outcomes on executive functions. The Wisconsin Cart Sorting Test (WCST) is the gold standard for evaluating executive functioning. Therefore, this article (1) reports the performance of the Wisconsin Card Sorting Test (WCST) in oncopediatric patients from Cali, Colombia; (2) indicates the reliability of the WCST; (3) describes the association between cancer type and executive functioning in patients; (4) describes the differences between patients with various executive deficits and their executive total scores; and (5) describes the association between cancer type and the presence of brain deficits based on the WCST. Methods: In this cross-sectional observational study, 24 oncopediatric patients were interviewed and evaluated via the WCST. Results: The mean age was 12.08 years (SD 3.98); 20.8% of the patients were women, 70.8% had a primary diagnosis of leukemia, 8% exhibited acquired brain deficits, and more than 75% displayed adequate functional indicators of executive functions. Robust statistics were employed to explore the differences between the types of diagnosis and performance in executive functions, and no statistically significant differences were found (p = 0.156). We found that the WCST has a reliable Cronbach’s α of 0.804. Oncopediatric patients without brain deficits presented strong results in terms of executive functions (p = 0.002), with a moderate effect size (0.727). Conclusions: The WCST is reliable for discriminating executive functioning among pediatric cancer patients. The evidence suggests that there were no differences in the executive functioning of the participants based on the types of cancer being evaluated.