Star Cancellation Test

Star Cancellation Test Evaluation Summary
  What does the tool measure? Unilateral Spatial Neglect (USN) in the near extra personal space
  What types of clients can the tool be used for? Patients with stroke
  Is this a screening or assessment tool? Screening
Time to administer Less than 5 minutes.
  Versions Laterally extended version of the Star Cancellation Test
Other Languages The words can be translated into the patients’ native language.
Measurement Properties
  Reliability – No studies have examined the internal consistency of the Star Cancellation Test.
– One study has examined the test-retest reliability of the Star Cancellation Test and reported excellent test-retest.
– No studies have examined the inter-rater reliability of the Star Cancellation Test.

The Star Cancellation Test correlated adequately with the Barthel Index, the Line Bisection Test, the Clock Drawing Test, and the Copy A Cross Test. The test had an excellent correlation with the Line Crossing Test and with the Indented Paragraph test.

One study reported that out of 4 different measures of USN (Line Crossing Test, Line Bisection Test, Star Cancellation Test, and Indented Paragraph), the Star Cancellation Test was the best predictor of functional outcome.

  Does the tool detect change in patients? Not applicable.
  Acceptability The Star Cancellation Test should be used as a screening tool rather than for clinical diagnosis of USN. Apraxia must be ruled out as this may affect the validity of test results. This test cannot be completed by proxy. Patients must be able to hold a pencil and visually discriminate between distractor items to complete. The measure cannot be used to differentiate between sensory neglect and motor neglect.
Feasibility The Star Cancellation Test requires no specialized training to administer and only minimal equipment is required (a pencil and the test paper). The test is simple to score and interpret (counting the number of small stars cancelled by patient out of a total of 54). A suggested cutoff score for the presence of USN is provided (< 44 indicates the presence of USN). The test is placed at the patient’s midline and the 2 small stars in the middle are used for demonstration.
How to obtain the tool? Please click here to see a copy of the Star Cancellation Test.