Open AccessClock‐drawing test as a screening tool for HIV‐associated neurocognitive disorder (HAND)
Author(s) -
Levy I,
Goldstein A,
Maor Y,
Rahav G,
Litachewsky V,
Fischel T
Publication year - 2012
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.7448/ias.15.6.18163
Subject(s) - neurocognitive , medicine , gold standard (test) , test (biology) , human immunodeficiency virus (hiv) , predictive value , psychiatry , family medicine , cognition , paleontology , biology
Current tests for diagnosing HIV‐associated neurocognitive dysfunction (HAND) consume time and energy and are not very practical as a screening tool in the busy clinic. The clock‐drawing test (CDT) was reported sensitive to subcortical pathology associated with periventricular and deep white matter. In addition, CDT has shown to be sensitive to executive dysfunction. Aim The aim of this study was to determine the value of a clock‐drawing test as a screening tool for diagnosing HAND. Methods: The CDT that we used was largely based on Rouleau et al. (1992). The patient is asked to draw a clock, first the frame, than the numbers, and than the hands showing the time 10 to 2. The interpretation is based on the following criteria: frame, numbers, hands, center, general impression. If acceptable‐2 points, non‐acceptable‐0, and acceptable but deviating‐1 point. Other validated neurocognitive tests (e.g. TMA, TMB, DSST, etc) were used as the “gold standard”. Results In the primary analysis 54 patients were included: 47 men and 7 women. Sensitivity was 77%, specificity 90%, positive predictive value 71.4%, negative predictive value 92.5%. In this preliminary study we found CDT to be a valid screening tool for HAND. It correlates highly with other well‐established screening tools, but demands less resources (human and technological). It is especially good for ruling out the disease.