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Commentary on “Meta‐analysis of memantine: Summary and commentary on the Cochrane Collaboration's systematic review.” Meaning and measurement in cognitive impairment
Author(s) -
Frank Lori B.
Publication year - 2006
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2006.02.006
Subject(s) - meaning (existential) , memantine , systematic review , cognitive impairment , library science , citation , psychology , medicine , cognition , gerontology , medline , computer science , dementia , psychotherapist , psychiatry , political science , law , disease , pathology
r v [ n T a i i s t r b In their commentary on the Cochrane meta-analysis of emantine presented in the inaugural issue of this journal, cShane and Schneider note that the positive effect of emantine (20 mg/d) on cognitive function at 28 weeks for atients with mild to moderate vascular dementia is not upported by clinical impression of change data “implying hat the cognitive effect does not translate into clinically elevant changes [1,2].” This is an extremely important oint for interpretation of data from any cognition trial as ell as for interpretation of meta-analyses and is timely iven the recent release of the US Food and Drug Adminstration (FDA) “Draft guidance for industry on patient eported outcome assessment for use in medical product evelopment” [3]. This guidance outlines best practices for ollection of intrinsically subjective patient-based data and dds regulatory impetus to evolving standards for instruent creation and interpretation; as such, the contents are ritical to the future of cognition treatment trials. Current measurement of clinical trial endpoints for cogition treatments is limited by mixed data on psychometric erformance of measures and by a lack of clinical signifiance thresholds to aid interpretation. The methods for etermining clinical significance used in other therapeutic reas could be more systematically applied to cognition trial ndpoints, particularly since such endpoints are frequently ased on clinician impression or the subjective perspective f an informant for the patient. In addition, the applicability f patient-reported outcomes measurement to cognitive disrders deserves closer attention. Using available methods or more formal incorporation of the patient and other inormant perspectives could improve measurement, as could nsuring capture of behavior and functioning in addition to ognition.