Diagnostic accuracy, effectiveness and cost for cognitive impairment and dementia screening of three short cognitive tests applicable to illiterates


Autoria(s): Carnero-Pardo, Cristóbal; Espejo-Martínez, Beatriz; López-Alcalde, Samuel; Espinosa-García, María; Sáez-Zea, Carmen; Hernández-Torres, Elisa; Navarro-Espigares, José Luis; Vílchez-Carrillo, Rosa
Data(s)

12/11/2012

12/11/2012

02/11/2011

Resumo

BACKGROUND Illiteracy, a universal problem, limits the utilization of the most widely used short cognitive tests. Our objective was to assess and compare the effectiveness and cost for cognitive impairment (CI) and dementia (DEM) screening of three short cognitive tests applicable to illiterates. METHODS Phase III diagnostic test evaluation study was performed during one year in four Primary Care centers, prospectively including individuals with suspicion of CI or DEM. All underwent the Eurotest, Memory Alteration Test (M@T), and Phototest, applied in a balanced manner. Clinical, functional, and cognitive studies were independently performed in a blinded fashion in a Cognitive Behavioral Neurology Unit, and the gold standard diagnosis was established by consensus of expert neurologists on the basis of these results. Effectiveness of tests was assessed as the proportion of correct diagnoses (diagnostic accuracy [DA]) and the kappa index of concordance (k) with respect to gold standard diagnoses. Costs were based on public prices at the time and hospital accounts. RESULTS The study included 139 individuals: 47 with DEM, 36 with CI, and 56 without CI. No significant differences in effectiveness were found among the tests. For DEM screening: Eurotest (k = 0.71 [0.59-0.83], DA = 0.87 [0.80-0.92]), M@T (k = 0.72 [0.60-0.84], DA = 0.87 [0.80-0.92]), Phototest (k = 0.70 [0.57-0.82], DA = 0.86 [0.79-0.91]). For CI screening: Eurotest (k = 0.67 [0.55-0.79]; DA = 0.83 [0.76-0.89]), M@T (k = 0.52 [0.37-0.67]; DA = 0.80 [0.72-0.86]), Phototest (k = 0.59 [0.46-0.72]; DA = 0.79 [0.71-0.86]). There were no differences in the cost of DEM screening, but the cost of CI screening was significantly higher with M@T (330.7 ± 177.1 €, mean ± sd) than with Eurotest (294.1 ± 195.0 €) or Phototest (296.0 ± 196. 5 €). Application time was shorter with Phototest (2.8 ± 0.8 min) than with Eurotest (7.1 ± 1.8 min) or M@T (6.8 ± 2.2 min). CONCLUSIONS Eurotest, M@T, and Phototest are equally effective. Eurotest and Phototest are both less expensive options but Phototest is the most efficient, requiring the shortest application time.

Journal Article; Research Support, Non-U.S. Gov't;

Funding was provided by the Carlos III National Health Research Institute (grant PI06/90034)

Identificador

Carnero-Pardo C, Espejo-Martínez B, López-Alcalde S, Espinosa-García M, Sáez-Zea C, Hernández-Torres E et al. Diagnostic Accuracy, Effectiveness and Cost for Cognitive Impairment and Dementia Screening of Three Short Cognitive Tests Applicable to Illiterates. PLoS ONE 6(11): e27069

1932-6203 (Online)

PMC3206887

http://hdl.handle.net/10668/618

22073256

10.1371/journal.pone.0027069

Idioma(s)

en

Publicador

Public Library of Science

Relação

PloS one

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0027069

Direitos

Acceso abierto

Palavras-Chave #Anciano #Anciano de 80 o más Años #Trastornos del Conocimiento #Demencia #Escolaridad #Femenino #Humanos #Masculino #Mediana Edad #Sensibilidad y Especificidad #Anciano de 80 o más Años #Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged::Aged, 80 and over #Medical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Dementia #Medical Subject Headings::Health Care::Population Characteristics::Socioeconomic Factors::Educational Status #Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans #Medical Subject Headings::Check Tags::Male #Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Sensitivity and Specificity #Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged #Medical Subject Headings::Psychiatry and Psychology::Mental Disorders::Delirium, Dementia, Amnestic, Cognitive Disorders::Cognition Disorders
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/published

Artículo