What Are the Minimal Detectable Changes in SDMT and Verbal Fluency Tests for Assessing Changes in Cognitive Performance in Persons with Multiple Sclerosis and Non-Multiple Sclerosis Controls?

2020 ◽  
Vol 83 (3) ◽  
pp. 263-270
Author(s):  
Eloi Magnin ◽  
Yoshimasa Sagawa ◽  
Thierry Moulin ◽  
Pierre Decavel

Introduction: Cognitive impairment is frequent in persons with multiple sclerosis (PwMS) and can impact on activities of daily living. The capacity to differentiate real changes from background statistical noise induced by human, instrumentational, and environmental variations inherent to the evaluation would improve cognitive assessments. Objective: To assess the short-term reproducibility of cognitive tests in non-multiple sclerosis (non-MS) persons and PwMS. Methods: Sixty-two PwMS and 19 non-MS persons performed 2 measurements, 1 week apart, of the Symbol Digit Modalities Test (SDMT) and phonological and semantic verbal fluency. Test-retest reliability was evaluated by the intraclass correlation coefficients (ICC) and agreement by standard error of measurement (SEM) and minimum detectable change (MDC). Results: The reliability of the cognitive variables studied had moderate to high ICC values (ICC > 0.8) in both populations. The threshold to consider a significant cognitive modification evaluated by SEM and MDC was lower in PwMS compared with non-MS persons. Conclusions: SDMT and verbal fluency have good short-term reproducibility in PwMS. Specific SEM and MDC cutoffs based on the same design of evaluation (especially retest timing) and to the targeted pathological population (MS vs. healthy) should systematically be used to consider cognitive modification as significant in research protocol as well as in clinical practice.

2021 ◽  
pp. 135245852110170
Author(s):  
Anissa Kalinowski ◽  
Gary Cutter ◽  
Nina Bozinov ◽  
Jessica A Hinman ◽  
Michael Hittle ◽  
...  

Background: The timed 25-foot walk (T25FW) is a key clinical outcome measure in multiple sclerosis patient management and clinical research. Objectives: To evaluate T25FW performance and factors associated with its change in the Multiple Sclerosis Outcome Assessments Consortium (MSOAC) Placebo Database ( n = 2465). Methods: We created confirmed disability progression (CDP) variables for T25FW and Expanded Disability Status Scale (EDSS) outcomes. We used intraclass correlation coefficients (ICCs) and Bland Altman plots to evaluate reliability. We evaluated T25FW changes and predictive validity using a mixed-effects model, survival analysis, and nested case–control analysis. Results: The mean baseline score for the T25FW in this study population was 9.2 seconds, median = 6.1 (standard deviation = 11.0, interquartile range (IQR) = 4.8, 9.0). The T25FW measure demonstrated excellent test–retest reliability (ICC = 0.98). Walk times increased with age, disability, disease type, and disease duration; relapses were not associated with an increase. Patients with T25FW progression had a faster time to EDSS-CDP compared to those without (hazards ratio (HR): 2.6; confidence interval (CI): 2.2, 3.1). Changes in the T25FW were more likely to precede changes in EDSS. Conclusion: This research confirms the association of the T25FW with disability and provides some evidence of predictive validity. Our findings support the continued use of the T25FW in clinical practice and clinical trials.


2021 ◽  
pp. 1-6
Author(s):  
Allison Oliva ◽  
Kristal M. Riska ◽  
Sherri L. Smith

Purpose: The purpose of this study was to determine the test–retest reliability and the minimum detectable change (MDC) scores of the Listening Self-Efficacy Questionnaire (LSEQ). Method: A total of 77 older adults who were experienced hearing aid users were administered the LSEQ in pen–paper format on two separate occasions. They were provided the first copy of the LSEQ in the clinic to take home to complete. Those participants who completed and returned the first copy of the questionnaire were then mailed a second copy of the LSEQ to complete and return approximately 2 weeks later. The mean subscale and total scale scores from the two administrations were compared using intraclass correlation coefficients (ICCs) to determine test–retest reliability of the measure. The MDC scores, or the minimum difference between scores to demonstrate a real change in self-efficacy levels, were also calculated for each subscale and the total scale. Results: The ICCs ranged from 0.786 to 0.920 for the subscale and total scale scores. The MDC scores for the subscale and total scale ranged from 14.3% to 19.1%. Conclusions: The results of this study indicate that the LSEQ has moderate to excellent test–retest reliability. The MDC scores demonstrate that the LSEQ has the potential to detect true changes in listening self-efficacy in older patients with hearing loss who use hearing aids. The LSEQ may aid clinicians in understanding listening self-efficacy in their patients and how their self-efficacy levels change with amplification.


2006 ◽  
Vol 86 (1) ◽  
pp. 66-76 ◽  
Author(s):  
Geert Verheyden ◽  
Godelieve Nuyens ◽  
Alice Nieuwboer ◽  
Pol Van Asch ◽  
Piet Ketelaer ◽  
...  

Abstract Background and Purpose. Standardized scales are a prerequisite for rehabilitation and research. This study was designed to determine the reliability and validity of scores on items of the trunk assessment of the Melsbroek Disability Scoring Test (MDST) and Trunk Impairment Scale (TIS) in people with multiple sclerosis (MS). Subjects. Thirty people with MS participated in the study. Methods. Interrater and test-retest reliability and construct validity were assessed. Results. Kappa and weighted kappa values for the items of the trunk assessment of the MDST ranged from .74 to .95, and the kappa and weighted kappa values for the TIS items ranged from .46 to 1.00. Intraclass correlation coefficients for interrater and test-retest agreement were .93 and .92, respectively, for the trunk assessment of the MDST and .97 and .95, respectively, for the TIS. Bland-Altman analysis showed consistency of scores without observer bias. Construct validity was established. Discussion and Conclusion. The MDST and TIS provide reliable assessments of the trunk and are valid scales for measuring trunk performance in people with MS. [Verheyden G, Nuyens G, Nieuwboer A, et al. Reliability and validity of trunk assessment for people with multiple sclerosis.


2021 ◽  
pp. 135245852110181
Author(s):  
KH Lam ◽  
P van Oirschot ◽  
B den Teuling ◽  
HE Hulst ◽  
BA de Jong ◽  
...  

Background: Early detection and monitoring of cognitive dysfunction in multiple sclerosis (MS) may be enabled with smartphone-adapted tests that allow frequent measurements in the everyday environment. Objectives: The aim of this study was to determine the reliability, construct and concurrent validity of a smartphone-adapted Symbol Digit Modalities Test (sSDMT). Methods: During a 28-day follow-up, 102 patients with MS and 24 healthy controls (HC) used the MS sherpa® app to perform the sSDMT every 3 days on their own smartphone. Patients performed the Brief International Cognitive Assessment for MS at baseline. Test–retest reliability (intraclass correlation coefficients, ICC), construct validity (group analyses between cognitively impaired (CI), cognitively preserved (CP) and HC for differences) and concurrent validity (correlation coefficients) were assessed. Results: Patients with MS and HC completed an average of 23.2 ( SD = 10.0) and 18.3 ( SD = 10.2) sSDMT, respectively. sSDMT demonstrated high test–retest reliability (ICCs > 0.8) with a smallest detectable change of 7 points. sSDMT scores were different between CI patients, CP patients and HC (all ps < 0.05). sSDMT correlated modestly with the clinical SDMT (highest r = 0.690), verbal (highest r = 0.516) and visuospatial memory (highest r = 0.599). Conclusion: Self-administered smartphone-adapted SDMT scores were reliable and different between patients who were CI, CP and HC and demonstrated concurrent validity in assessing information processing speed.


2008 ◽  
Vol 22 (6) ◽  
pp. 737-744 ◽  
Author(s):  
I-Ping Hsueh ◽  
Miao-Ju Hsu ◽  
Ching-Fan Sheu ◽  
Su Lee ◽  
Ching-Lin Hsieh ◽  
...  

Objective. To provide empirical justification for selecting motor scales for stroke patients, the authors compared the psychometric properties (validity, responsiveness, test-retest reliability, and smallest real difference [SRD]) of the Fugl-Meyer Motor Scale (FM), the simplified FM (S-FM), the Stroke Rehabilitation Assessment of Movement instrument (STREAM), and the simplified STREAM (S-STREAM). Methods. For the validity and responsiveness study, 50 inpatients were assessed with the FM and the STREAM at admission and discharge to a rehabilitation department. The scores of the S-FM and the S-STREAM were retrieved from their corresponding scales. For the test-retest reliability study, a therapist administered both scales on a different sample of 60 chronic patients on 2 occasions. Results. Only the S-STREAM had no notable floor or ceiling effects at admission and discharge. The 4 motor scales had good concurrent validity (rho ≥ .91) and satisfactory predictive validity (rho = .72-.77). The scales showed responsiveness (effect size d ≥ 0.34; standardized response mean ≥ 0.95; P < .0001), with the S-STREAM most responsive. The test-retest agreements of the scales were excellent (intraclass correlation coefficients ≥ .96). The SRD of the 4 scales was 10% of their corresponding highest score, indicating acceptable level of measurement error. The upper extremity and the lower extremity subscales of the 4 showed similar results. Conclusions. The 4 motor scales showed acceptable levels of reliability, validity, and responsiveness in stroke patients. The S-STREAM is recommended because it is short, responsive to change, and able to discriminate patients with severe or mild stroke.


2018 ◽  
Vol 6 (s2) ◽  
pp. S252-S263 ◽  
Author(s):  
Lisa M. Barnett ◽  
Owen Makin

Assessing young children’s perceptions is commonly done one on one with an interviewer. An app enables several children to complete the scale at once. The objective was to describe an app to assess children’s perceptions of movement competence and then present consistency of child responses. The Pictorial Scale of Perceived Movement Skill Competence (PMSC) has fundamental movement skill (FMS; e.g., catch) and play items (e.g., cycling). The PMSC android app has the same items and images but children complete it independently with audio. Intraclass correlation coefficients (ICC) assessed i) test-retest reliability using the PMSC app on 18 items in 42 children (M = 6.8 yrs) and ii) consistency between measures for 13 FMS items in 44 children (M = 8.5 yrs). Over time (M = 6.9 days, SD = 0.35) the full PMSC had good consistency (ICC = 0.79, 95% CI 0.64–0.88) and the FMS items had moderate consistency (ICC = 0.68, 95% CI 0.47–0.81). There was good agreement between the app and interview for FMS items (ICC = 0.86, 95% CI 0.76–0.92). Locomotor items were less consistent. The PMSC app can generally be recommended. Future research could investigate how different forms of digital assessment affect children’s perception.


2020 ◽  
Vol 47 (4) ◽  
pp. 479-486
Author(s):  
Yuki Kondo ◽  
Kyota Bando ◽  
Yosuke Ariake ◽  
Wakana Katsuta ◽  
Kyoko Todoroki ◽  
...  

BACKGROUND: The reliability of the evaluation of the Balance Evaluation Systems Test (BESTest) and its two abbreviated versions are confirmed for balance characteristics and reliability. However, they are not utilized in cases of spinocerebellar ataxia (SCA). OBJECTIVE: We aimed to examine the test-retest reliability and minimal detectable change (MDC) of the BESTest and its abbreviated versions in persons with mild to moderate spinocerebellar ataxia. METHODS: The BESTest was performed in 20 persons with SCA at baseline and one month later. The scores of the abbreviated version of the BESTest were determined from the BESTest scores. The interclass correlation coefficient (1,1) was used as a measure of relative reliability. Furthermore, we calculated the MDC in the BESTest and its abbreviated versions. RESULTS: The intraclass correlation coefficients (1,1) and MDC at 95% confidence intervals were 0.92, 8.7(8.1%), 0.91, 4.1(14.5%), and 0.81, 5.2(21.6%) for the Balance, Mini-Balance, and Brief-Balance Evaluation Systems Tests, respectively. CONCLUSIONS: The BESTest and its abbreviated versions had high test-retest reliability. The MDC values of the BESTest could enable clinicians and researchers to interpret changes in the balance of patients with SCA more precisely.


2016 ◽  
Vol 11 (2) ◽  
pp. 154-158 ◽  
Author(s):  
Lucas A. Pereira ◽  
Andrew A. Flatt ◽  
Rodrigo Ramirez-Campillo ◽  
Irineu Loturco ◽  
Fabio Y. Nakamura

Purpose:To compare the LnRMSSD and the LnRMSSD:RR values obtained during a 5-min stabilization period with the subsequent 5-min criterion period and to determine the time course for LnRMSSD and LnRMSSD:RR stabilization at 1-min analysis in elite team-sport athletes.Participants:35 elite futsal players (23.9 ± 4.5 y, 174.2 ± 4.0 cm, 74.0 ± 7.5 kg, 1576.2 ± 396.3 m in the Yo-Yo test level 1).Methods:The RR-interval recordings were obtained using a portable heart-rate monitor continuously for 10 min in the seated position. The 2 dependent variables analyzed were LnRMSSD and LnRMSSD:RR. To calculate the magnitude of the differences between time periods, effect-size (ES) analysis was conducted. To assess the levels of agreement, intraclass correlation coefficients (ICC) and Bland-Altman plots were used.Results:The LnRMSSD and LnRMSSD:RR values obtained during the stabilization period (0–5 min) presented very large to nearly perfect ICCs with the values obtained during the criterion period (5–10 min), with trivial ESs. In the ultra-short-term analysis (ie, 1-min segments) the data showed slightly less accurate results, but only trivial to small differences with very large to nearly perfect ICCs were found.Conclusion:LnRMSSD and LnRMSSD:RR can be recorded in 5 min without traditional stabilization periods under resting conditions in team-sport athletes. The ultra-short-term analysis (1 min) also revealed acceptable levels of agreement with the criterion.


1989 ◽  
Vol 9 (5) ◽  
pp. 259-272 ◽  
Author(s):  
Jane Case-Smith

The Posture and Fine Motor Assessment of Infants (PFMAI) (Case-Smith, 1987) is a newly developed instrument for assessing the quality of motor function in infants. The test measures components of posture and fine motor control as they first develop. The purpose of this study was to support the test's reliability and validity. Interrater reliability, analyzed with intraclass correlation coefficients (ICCs), was high (.989 for total scores). Test-retest reliability, measured by ICCs, was .853 and .913 for the two test sections. The PFMAI demonstrated concurrent validity with the Peabody Developmental Motor Scales, Revised (Folio & Fewell, 1983) (correlations were .673 and .829 for the individual sections). Scores on the PFMAI were highly correlated with the infant's ages (.892 to .941); this finding provided one indication of construct validity.


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