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Diagnostic accuracy of a new instrument for detecting cognitive dysfunction
Author(s) -
Cercy Steven P.
Publication year - 2012
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2802
Subject(s) - receiver operating characteristic , cutoff , cognition , neuropsychology , area under the curve , diagnostic accuracy , psychometrics , psychology , medicine , psychiatry , clinical psychology , physics , quantum mechanics
Background Effective screening of cognitive disorders is limited by psychometric and practical properties of available instruments. The Brief Cognitive Screen (BCS) was developed to improve sensitivity and overall diagnostic accuracy of case detection for cognitive dysfunction in a quick and convenient format. Methods This validation study compared psychometric properties of the BCS with the Mini mental state examination (MMSE) in 308 patients with suspected or known disorders of cognition. Diagnostic accuracy of the MMSE was determined using the traditional 23/24 clinical cutoff and area under the curve (AUC) from receiver operating characteristics (ROC) analyses. Diagnostic accuracy of BCS summary scores and components was determined by ROC analyses. Comprehensive neuropsychological evaluation served as the criterion standard for determining cognitive dysfunction. Results The MMSE sensitivity (34.8%) was inadequate at the 23/24 cutoff. Under ROC analyses, diagnostic accuracy of a BCS summary score was superior (AUC = 0.950) to the MMSE total score (AUC = 0.862) for the total sample. Excluding all patients with a history of cognitive deficit, classification accuracy of the BCS remained high (AUC = 0.936). Conclusions Findings suggest that BCS is an effective, convenient alternative screening instrument for use in clinical populations with suspected cognitive dysfunction. Copyright © 2011 John Wiley & Sons, Ltd.