Premium
Validation of the Freund Clock Drawing Test as a screening tool to detect cognitive dysfunction in elderly cancer patients undergoing comprehensive geriatric assessment
Author(s) -
Lycke Michelle,
Ketelaars Lore,
Boterberg Tom,
Pottel Lies,
Pottel Hans,
Vergauwe Philippe,
Goethals Laurence,
Van Eygen Koen,
Werbrouck Patrick,
Debruyne David,
Derijcke Sofie,
Borms Marleen,
Ghekiere Véronique,
Wildiers Hans,
Debruyne Philip R.
Publication year - 2014
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.3540
Subject(s) - receiver operating characteristic , medicine , cognitive impairment , gold standard (test) , area under the curve , test (biology) , mini–mental state examination , cognition , cancer , cutoff , physical therapy , oncology , psychiatry , disease , paleontology , physics , quantum mechanics , biology
Objective We aimed to validate the Freund Clock Drawing Test (CDT), with its predefined cutoff score of ≤4, as a screening tool to detect elderly cancer patients in need of a more in‐depth cognitive evaluation within a comprehensive geriatric assessment (CGA). Methods Patients aged 70 years or older with a histologically confirmed diagnosis of cancer were evaluated with a full CGA, including CDT and Folstein Mini Mental State Examination (MMSE) as gold standard. Validation of the Freund CDT was defined in terms of diagnostic accuracy of the test through receiver operating characteristics (ROC)‐analysis. To accept the Freund CDT as a screening tool, we estimated that the area under the ROC curve (AUC) had to differ significantly from 0.70 with an AUC of at least 0.85. Results Two hundred elderly cancer patients with a mean age of 79.0 years were included. Four patients were excluded from the analyses because of invalid results. Potential cognitive impairment (MMSE ≤23) was observed in 27.0% of patients. Based on of the AUC ± SE, the Freund CDT showed excellent diagnostic performance (0.95 ± 0.17). Furthermore, it provided excellent sensitivity (94.3%) and high specificity (87.4%). Conclusions Our results indicate that the Freund CDT can be used as an initial screening tool to detect elderly cancer patients in need of a more in‐depth cognitive assessment within CGA, instead of the MMSE. Copyright © 2014 John Wiley & Sons, Ltd.