Diagnostic accuracy of the International HIV Dementia Scale and HIV Dementia Scale: A meta-analysis

This aim of this study was to assess the diagnostic accuracy of the International HIV Dementia Scale (IHDS) or HIV Dementia Scale (HDS) for the diagnosis of HIV-associated neurocognitive disorders (HAND). A comprehensive and systematic search was carried out in PubMed and EMBASE databases. Sensitivity, specificity, Q(*)-values, summary receiver operating characteristic curves and other measures of accuracy of IHDS or HDS in the diagnosis of HAND were summarized. Summary receiver operator characteristic (SROC) curve analysis for HAND data demonstrates a pooled sensitivity of 0.90 [95% confidence interval (CI), 0.88-0.91] and overall specificity of 0.96 (95% CI, 0.95-0.97) for IHDS, the Q(*)-value for IHDS was 0.9195 and the diagnostic odds ratio (DOR) was 162.28 (95% CI, 91.82-286.81). HDS had an overall sensitivity of 0.39 (95% CI, 0.34-0.43) and specificity of 0.90 (95% CI, 0.89-0.91), the Q(*)-value for HDS was 0.6321 and DOR was 5.81 (95% CI, 3.64-9.82). There was significant heterogeneity for studies that reported IHDS and HDS. This meta-analysis has shown that IHDS and HDS may offer high diagnostic performance accuracy for the detection of HAND in primary health care and resource-limited settings. IHDS and HDS may require reformed neuropsychological characterization of impairments in accordance with regional culture and language in future international studies.