Accuracy of Telephone-Based Cognitive Screening Tests: Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (5) ◽  
pp. 460-471
Author(s):  
Emma Elliott ◽  
Claire Green ◽  
David J. Llewellyn ◽  
Terence J. Quinn
Keyword(s):  
Meta Analysis ◽  
Cognitive Status ◽  
Screening Tests ◽  
Test Accuracy ◽  
Supporting Evidence ◽  
Cognitive Screening ◽  
Cognitive Assessments ◽  
Face To Face ◽  
The Face ◽  
The Many

Background: Telephone-based cognitive assessments may be preferable to in-person testing in terms of test burden, economic and opportunity cost. Objective: We sought to determine the accuracy of telephone-based screening for the identification of dementia or Mild Cognitive Impairment (MCI). Methods: Five multidisciplinary databases were searched. Two researchers independently screened articles and extracted data. Eligible studies compared any multi-domain telephone-based assessment of cognition to the face-to-face diagnostic evaluation. Where data allowed, we pooled test accuracy metrics using the bivariate approach. Results: From 11,732 titles, 34 papers were included, describing 15 different tests. There was variation in test scoring and quality of included studies. Pooled analyses of accuracy for dementia: Telephone Interview for Cognitive Status (TICS) (<31/41) sensitivity: 0.92, specificity: 0.66 (6 studies); TICSmodified (<28/50) sensitivity: 0.91, specificity: 0.91 (3 studies). For MCI: TICS-modified (<33/50) sensitivity: 0.82, specificity: 0.87 (3 studies); Telephone-Montreal Cognitive Assessment (<18/22) sensitivity: 0.98, specificity: 0.69 (2 studies). Conclusion: There is limited diagnostic accuracy evidence for the many telephonic cognitive screens that exist. The TICS and TICS-m have the greatest supporting evidence; their test accuracy profiles make them suitable as initial cognitive screens where face to face assessment is not possible.

scholarly journals Cognitive Assessment via Telephone: A Scoping Review of Instruments

2020 ◽  
Vol 35 (8) ◽  
pp. 1215-1233 ◽  
Author(s):  
Anne R Carlew ◽  
Hudaisa Fatima ◽  
Julia R Livingstone ◽  
Caitlin Reese ◽  
Laura Lacritz ◽  
...  
Keyword(s):  
Neuropsychological Assessment ◽  
Scoping Review ◽  
Cognitive Assessment ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Cognitive Screening ◽  
Cognitive Assessments ◽  
Face To Face ◽  
The Face ◽  
Remote Assessment

Abstract Objective Telephone-based cognitive assessment (TBCA) has long been studied but less widely adopted in routine neuropsychological practice. Increased interest in remote neuropsychological assessment techniques in the face of the coronavirus 2019 (COVID-19) pandemic warrants an updated review of relevant remote assessment literature. While recent reviews of videoconference-based neuropsychological applications have been published, no updated compilation of empirical TBCA research has been completed. Therefore, this scoping review offers relevant empirical research to inform clinical decision-making specific to teleneuropsychology. Method Peer-reviewed studies addressing TBCA were included. Broad search terms were related to telephone, cognitive, or neuropsychological assessment and screening. After systematic searching of the PubMed and EBSCO databases, 139 relevant articles were retained. Results In total, 17 unique cognitive screening measures, 20 cognitive batteries, and 6 single-task measures were identified as being developed or adapted specifically for telephone administration. Tables summarizing the identified cognitive assessments, information on diagnostic accuracy, and comparisons to face-to-face cognitive assessment are included in supplementary materials. Conclusions Overall, literature suggests that TBCA is a viable modality for identifying cognitive impairment in various populations. However, the mode of assessment selected clinically should reflect an understanding of the purpose, evidence, and limitations for various tests and populations. Most identified measures were developed for research application to support gross cognitive characterization and to help determine when more comprehensive testing was needed. While TBCA is not meant to replace gold-standard, face-to-face evaluation, if appropriately utilized, it can expand scope of practice, particularly when barriers to standard neuropsychological assessment occur.

Cognitive screening tools for identification of dementia in illiterate and low-educated older adults, a systematic review and meta-analysis

2017 ◽  
Vol 29 (6) ◽  
pp. 897-929 ◽  
Author(s):  
Stella-Maria Paddick ◽  
William K. Gray ◽  
Jackie McGuire ◽  
Jenny Richardson ◽  
Catherine Dotchin ◽  
...  
Keyword(s):  
Older Adults ◽  
Validation Studies ◽  
Meta Analysis ◽  
Significant Proportion ◽  
Educational Background ◽  
Screening Tools ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Low Literacy ◽  
Prevalence Studies

ABSTRACTBackground:The majority of older adults with dementia live in low- and middle-income countries (LMICs). Illiteracy and low educational background are common in older LMIC populations, particularly in rural areas, and cognitive screening tools developed for this setting must reflect this. This study aimed to review published validation studies of cognitive screening tools for dementia in low-literacy settings in order to determine the most appropriate tools for use.Method:A systematic search of major databases was conducted according to PRISMA guidelines. Validation studies of brief cognitive screening tests including illiterate participants or those with elementary education were eligible. Studies were quality assessed using the QUADAS-2 tool. Good or fair quality studies were included in a bivariate random-effects meta-analysis and a hierarchical summary receiver operating characteristic (HSROC) curve constructed.Results:Forty-five eligible studies were quality assessed. A significant proportion utilized a case–control design, resulting in spectrum bias. The area under the ROC (AUROC) curve was 0.937 for community/low prevalence studies, 0.881 for clinic based/higher prevalence studies, and 0.869 for illiterate populations. For the Mini-Mental State Examination (MMSE) (and adaptations), the AUROC curve was 0.853.Conclusion:Numerous tools for assessment of cognitive impairment in low-literacy settings have been developed, and tools developed for use in high-income countries have also been validated in low-literacy settings. Most tools have been inadequately validated, with only MMSE, cognitive abilities screening instrument (CASI), Eurotest, and Fototest having more than one published good or fair quality study in an illiterate or low-literate setting. At present no screening test can be recommended.

Agreement between telehealth and face-to-face assessment of intellectual ability in children with specific learning disorder

2018 ◽  
Vol 25 (7) ◽  
pp. 431-437 ◽  
Author(s):  
Marie Antoinette Hodge ◽  
Rebecca Sutherland ◽  
Kelly Jeng ◽  
Gillian Bale ◽  
Paige Batta ◽  
...  
Keyword(s):  
Intellectual Ability ◽  
Cognitive Assessments ◽  
Potential Cost ◽  
Web Based ◽  
Face To Face ◽  
Specific Learning Disorder ◽  
South Wales ◽  
The Face ◽  
Administration Method ◽  
Future Work

Introduction Access to cognitive assessments for children living remotely is limited. Telehealth represents a potential cost- and time-effective solution. A pilot study was conducted to determine the feasibility of telehealth to assess cognitive function in children with learning difficulties. Methods Thirty-three children (median age = 9 years 11 months), recruited from the New South Wales (NSW) Centre for Effective Reading, underwent assessment of intellectual ability. Comparisons were made between the intellectual ability index scores obtained by a psychologist sitting face-to-face with the children and another psychologist via telehealth using a web-based platform, Coviu. Results The telehealth administration method yielded comparable results to the face-to-face method. Correlation analyses showed high associations between the testing methodologies on the intellectual ability indices (correlation coefficient range = 0.981–0.997). Discussion Findings indicate that telehealth may be an alternative to face-to-face cognitive assessment. Future work in a broader range of cognitive tests and wider range of clinical populations is warranted.

Test Accuracy of Cognitive Screening Tests for Diagnosis of Dementia and Multidomain Cognitive Impairment in Stroke

Stroke ◽  
2014 ◽  
Vol 45 (10) ◽  
pp. 3008-3018 ◽  
Author(s):  
Rosalind Lees ◽  
Johann Selvarajah ◽  
Candida Fenton ◽  
Sarah T. Pendlebury ◽  
Peter Langhorne ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Screening Tests ◽  
Test Accuracy ◽  
Cognitive Screening ◽  
Diagnosis Of Dementia

scholarly journals A Meta-analysis of Clinical Screening Tests for Obstructive Sleep Apnea

2009 ◽  
Vol 110 (4) ◽  
pp. 928-939 ◽  
Author(s):  
Satya Krishna Ramachandran ◽  
Lydia A. Josephs
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Screening Test ◽  
Meta Analysis ◽  
False Negative ◽  
Significant Proportion ◽  
Screening Tests ◽  
Test Accuracy ◽  
Clinical Screening ◽  
Obstructive Sleep

The purpose of this meta-analysis is to compare clinical screening tests for obstructive sleep apnea and establish an evidence base for their preoperative use. Diagnostic odds ratios were used as summary measures of accuracy, and false-negative rates were used as measures of missed diagnosis with each screening test in this review. Metaregression revealed that clinical models, logarithmic equations, combined techniques, cephalometry, and morphometry are significant characteristics, whereas body mass index, history of hypertension, and nocturnal choking are significant test elements associated with higher diagnostic accuracy. Test accuracy in repeated validation studies of the same screening test is variable, suggesting an underlying heterogeneity in either the clinical presentation of obstructive sleep apnea or the measured clinical elements of these models. Based on the false-negative rates, it is likely that most of the clinical screening tests will miss a significant proportion of patients with obstructive sleep apnea.

scholarly journals Screening for dementia: Q* index as a global measure of test accuracy revisited

2020 ◽  
Author(s):  
Andrew J Larner
Keyword(s):  
Odds Ratio ◽  
Meta Analysis ◽  
Roc Curves ◽  
Diagnostic Odds Ratio ◽  
Test Accuracy ◽  
Cognitive Screening ◽  
Optimal Test ◽  
Global Parameter ◽  
Accuracy Study ◽  
Q Index

AbstractReceiver operating characteristic (ROC) curves intersect the downward diagonal through ROC space at a point, the Q* index, where by definition sensitivity and specificity are equal. Aside from its use in meta-analysis, Q* index has also been suggested as a possible global parameter summarising test accuracy of cognitive screening instruments and as a definition for optimal test cut-off. Area under the ROC curve (AUC ROC) is a recognised measure of test accuracy. This study compared different methods for determining Q* index (both graphical and calculation from diagnostic odds ratio) and AUC ROC (integration and calculation from diagnostic odds ratio) using the dataset of a prospective screening test accuracy study of the Mini-Addenbrooke’s Cognitive Examination. The different methods did not agree. DOR-based calculations gave a very sensitive cut-off but with poorer global metrics than the graphical method. DOR-based calculations are not recommended for defining optimal test cut-off or test accuracy.

The consistency of neuropsychological assessments performed via telecommunication and face to face

2000 ◽  
Vol 6 (3) ◽  
pp. 147-151 ◽  
Author(s):  
Kim T Kirkwood ◽  
David F Peck ◽  
Lindsay Bennie
Keyword(s):  
Cognitive Assessment ◽  
Psychiatric Patients ◽  
Cognitive Assessments ◽  
Participant Satisfaction ◽  
Face To Face ◽  
The Face ◽  
History Of ◽  
Neuropsychological Assessments ◽  
Order Of Presentation

Previous studies have suggested that cognitive assessments of adult psychiatric patients can be carried out as reliably via teleconsultation as they can face to face. However, the designs of these studies have often been less than satisfactory. The present study used videoconferencing at 128 kbit/s for the cognitive assessment of individuals with a history of alcohol abuse. Twenty-seven participants were given a range of assessments with two equivalent forms. One of the forms was given via videoconferencing and the other face to face. All participants were assessed using both media and the order of presentation was balanced across participants. Aspects of participant satisfaction with teleconsultations were also assessed, on 10-point scales. The teleconsultations were significantly longer (mean 40.7 min, SD 6.4) than the face-to-face sessions (mean 33.0 min, SD 5.3). For most of the outcome measures, cognitive assessment via teleconsultation produced similar results to face-to-face assessment. Most participants expressed high overall satisfaction with the teleconsultation (mean rating 8.2). The average ratings for the sound quality (mean 7.6) and visual quality of the equipment (mean 7.9) were also high. The findings imply that it is not necessary for patients and neuropsychologists to be present at the same location for cognitive assessments to be carried out.

Video-interpreting for cognitive assessments: An intervention study and micro-costing analysis

2020 ◽  
pp. 1357633X2091444
Author(s):  
Kerry Hwang ◽  
Anurika De Silva ◽  
Julie A Simpson ◽  
Dina LoGiudice ◽  
Lidia Engel ◽  
...  
Keyword(s):  
National Level ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Linguistically Diverse ◽  
Mean Difference ◽  
Cognitive Screening ◽  
Cognitive Assessments ◽  
Face To Face ◽  
Assessment Scores ◽  
Costing Analysis

Introduction Evidence in the literature demonstrates the reliability of cognitive screening assessments using video technology in English-speaking older populations. However, this has not been tested in older culturally and linguistically diverse (CALD) populations who require an interpreter, and what the associated costs would be. The aim was to determine if the Rowland Universal Dementia Assessment Scale (RUDAS) and the Geriatric Depression Scale (GDS) could be reliably administered over video-interpreting methods compared with face-to-face interpreting. In addition, the study aims to compare the costs of video-interpreting with the costs of face-to-face interpreting. Methods We compared similarity of the RUDAS and GDS scores when administered face-to-face and via video-interpreting. The similarity of scores between methods was analysed using paired t-tests and Bland–Altman plots. A costing analysis was done using a micro-costing approach to estimate the costs of video-interpreting compared with face-to-face, extrapolated to a national level. Results Analysis found no significant differences in the mean assessment scores between video-interpreting and face-to-face (RUDAS mean difference: −0.36; 95% confidence interval (CI): −1.09, 0.38, GDS mean difference: 0.22; 95% CI: −0.38, 0.83). Bland–Altman plots demonstrated that 71% of RUDAS scores and 82% of GDS scores were within the maximum allowed difference of ±2 units. Costing analysis showed a A$7 saving per assessment when using video-interpreting compared with face-to-face, with a total national saving of A$247,350. Discussion Video-interpreting was found to be as reliable as face-to-face interpreting for both RUDAS and GDS assessments. Cost analysis indicates that video-interpreting is cheaper than face-to-face interpreting.

scholarly journals Links between Cognitive Status and Trace Element Levels in Hair for an Environmentally Exposed Population: A Case Study in the Surroundings of the Estarreja Industrial Area

2019 ◽  
Vol 16 (22) ◽  
pp. 4560 ◽  
Author(s):  
Marina M. S. Cabral Pinto ◽  
Paula Marinho-Reis ◽  
Agostinho Almeida ◽  
Edgar Pinto ◽  
Orquídia Neves ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Industrial Area ◽  
Cognitive Status ◽  
Anthropogenic Sources ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Predictive Diagnosis ◽  
Exposed Population ◽  
Icp Ms ◽  
Hair Samples

In the present study, trace elements (TE) levels were evaluated in scalp hair along the continuum from healthy subjects (HS) to patients suffering from subjective memory concerns (SMC), and/or mild cognitive impairment (MCI), and those with already installed dementia (DEM) in order to: (i) assess the effects of environmental and lifestyle factors on TE concentrations and (ii) evaluate the analyzed elements as possible diagnostic biomarkers for the disease. The study involved 79 mainly permanent residents, >55 years old, from the city of Estarreja (northern Portugal), a former industrial area. The health status of the participants was assessed by means of a complete socio-demographic questionnaire and through cognitive screening tests, namely the Mini-Mental State Examination (MMSE). The test scores were categorized and used in the statistical analysis. Hair samples were collected and analyzed by inductively coupled plasma-mass spectrometry (ICP-MS) ICP-MS for selected TE. Dementia appears to be associated with higher age, the female gender, lower education level, and longer residence time in the study area. In addition, most of the participants diagnosed with dementia frequently consume home-grown foodstuffs, some irrigated with contaminated well water. The calculation of the TE enrichment factors of soil samples collected in kitchen gardens/small farms in the vicinity of the Estarreja Chemical Complex (ECC) reinforces the degree of Hg soil contamination in the area, due to anthropogenic sources that can be a source for the population Hg exposure route among others. Mercury levels in hair differed significantly between the four individual groups (HS, SMC, MCI, and DEM), increasing from healthy to dementia participants. Improved diagnostic results can be obtained using hair TE signatures coupled with MMSE scores. This strategy may prove useful for predictive diagnosis in population screening for cognitive impairment.

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