Adjusting the Thai version of the Addenbrooke’s Cognitive Examination III for education to screen for dementia

2021 ◽  
Author(s):  
Thammanard Charernboon
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Receiver Operating Characteristic Curve ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Education Level ◽  
Operating Characteristic Curve ◽  
Normal Controls ◽  
Addenbrooke’S Cognitive Examination

Aim: To examine whether education adjusted cut-off points of the Thai version of the ACE-III improve diagnostic accuracy in the detection of mild cognitive impairment (MCI) and dementia. Materials & methods: There were 172 participants consisting of 70 normal controls, 49 people with MCI and 53 patients with dementia. Results: To screen for MCI, the adjusted for education method yielded greater accuracy for the area under the receiver operating characteristic curve (AuROC) than the unadjusted method (0.9–0.92 vs 0.86). For the detection of dementia, when applying the education correction, AuROC increased from 0.87 (unadjusted) to 0.91 for the education >6 group, but there was no improvement for education ≤6 group (AuROC 0.86). Conclusion: The use of adjusted cut-off score for education level could increase the diagnostic accuracy of the test.

scholarly journals Handgrip Strength Could Be an Early Predictor of Cognitive Impairment in the Chinese Population

2021 ◽  
Author(s):  
Hang Su ◽  
Xiaokang Sun ◽  
Fang Li ◽  
Qihao Guo
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Receiver Operating Characteristic Curve ◽  
Chinese Population ◽  
Operating Characteristic ◽  
Handgrip Strength ◽  
Characteristic Curve ◽  
Normal Individuals ◽  
Operating Characteristic Curve ◽  
Early Predictor

Abstract BackgroundThis study aimed to explore the level and changes of handgrip strength in pre-clinical Alzheimer’s disease (AD) and AD participates, and to evaluate the association between handgrip strength and cognitive function.Methods1431 participants from the memory clinic of Shanghai JiaoTong University Affiliated Sixth People’s Hospital and community were enrolled into the final analysis, included 596 AD, 288 mild cognitive impairment (MCI), and 547 normal individuals (NC). All participants received a comprehensive neuropsychological assessment. Mini-mental state examination (MMSE), montreal cognitive assessment-Basic (MoCA-BC), and the Chinese version of the Addenbrooke’s cognitive examination (ACE-III-CV) were used as cognitive tests. The receiver operating characteristic curve (ROC) was plotted to assess the power of the handgrip strength as a screening measure to discriminate AD and MCI.ResultsThe results showed that participants with lower handgrip strength had lower MMSE, MoCA-BC, and ACE-III-CV scores (P <0.05). Handgrip strength in the mild cognitive impairment (MCI) group was significantly lower than that of normal individuals (NC), and the AD group had a further decline (both P<0.01). Multivariate logistic regression was performed with the handgrip strength quartiles, the results showed ORs of AD for increasing levels of handgrip strength were 1.00, 0.58 (0.46–0.78), 0.51 (0.36–0.73), and 0.50 (0.35–0.68), showing a decreasing trend (Pfor trend < 0.001). The receiver operating characteristic curve demonstrated that the handgrip strength cut-off points for identification of AD were16.8 kg and 20.7 kg among the female participates above and under 70 yrs, 24.4 kg and 33.3 kg for the male participates above and under 70 yrs, respectively.ConclusionsStronger handgrip strength was associated with better performances on cognitive function, handgrip strength could be an early predictor of cognitive impairment in the Chinese population. The current study provides a foundation for non-cognitive features as early predictors of cognitive impairment, researches on the association between frailty and cognition will be further developed in the future.

scholarly journals Identifying Cancer-Related Cognitive Impairment Using the FACT-Cog Perceived Cognitive Impairment

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Kathleen Van Dyk ◽  
Catherine M Crespi ◽  
Laura Petersen ◽  
Patricia A Ganz
Keyword(s):  
Cognitive Impairment ◽  
Cancer Survivors ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Self Report ◽  
Good Ability ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Abstract Cancer-related cognitive impairment (CRCI) is a concerning problem for many cancer survivors. Evaluating patients for CRCI has been a challenge, in part because of a lack of standardized practices. Self-report instruments are often used to assess CRCI, but there are no validated cutpoints. We present the results of receiver operating characteristic curve analysis identifying cutpoints of the Functional Assessment of Cancer Therapy—Cognition perceived cognitive impairment (PCI) in female breast cancer survivors for identifying CRCI cases. We defined presence of CRCI based on elevated complaints on the Patient’s Assessment of Own Functioning Inventory compared with healthy control scores. Our results indicate that scores less than 54 in PCI scores using 18 items and scores less than 60 in PCI scores using 20 items exhibited good ability to discriminate CRCI cases from noncases (area under the receiver operating characteristic curve was 0.84 [95% CI = 0.73 to 0.94]). These preliminary results represent an important contribution toward standardizing practices across CRCI studies.

Defining ‘optimal’ test cut-off using global test metrics: evidence from a cognitive screening instrument

2020 ◽  
Vol 10 (4) ◽  
pp. 223-230
Author(s):  
Andrew J Larner
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Test Accuracy ◽  
Cognitive Screening ◽  
Global Test ◽  
Operating Characteristic Curve ◽  
Addenbrooke’S Cognitive Examination ◽  
Receiver Operating

Aim: To examine the variation of several global metrics of test accuracy with test cut-off for the diagnosis of dementia. These metrics included some based on the receiver operating characteristic curve, such as Youden index, and some independent of receiver operating characteristic curve, such as correct classification accuracy. Materials & methods: Data from a test accuracy study of Mini-Addenbrooke’s Cognitive Examination were used to calculate and plot each global measure against test cut-off. Results: Different ‘optimal’ cut-points were identified for the different global measures, with a spread of ten points in observed optimal cut-off in the 30-point Mini-Addenbrooke’s Cognitive Examination scale. Using these optima gave a large variation in test sensitivity from very high (diagnostic odds ratio) to very low (likelihood to be diagnosed or misdiagnosed), but all had high negative predictive value. Conclusion: The method used to determine the cut-off of cognitive screening instruments may have significant implications for test performance.

Conventional administration and scoring procedures suppress the diagnostic accuracy of a performance-based test designed to assess balance ability in lower limb prosthesis users

2019 ◽  
Vol 43 (4) ◽  
pp. 402-408 ◽  
Author(s):  
Andrew Sawers ◽  
Brian J Hafner
Keyword(s):  
Diagnostic Accuracy ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Practice Effects ◽  
Balance Test ◽  
Walking Test ◽  
History Of ◽  
Operating Characteristic Curve

Background:Practice effects have been observed among performance-based clinical tests administered to prosthesis-users. Their impact on test applications remains unknown.Objective:To determine whether scoring a clinical balance test using conventional procedures that do not accommodate practice effects reduces its diagnostic accuracy relative to scoring it using recommended procedures that do accommodate practice effects.Study Design:Cross-sectional study.Methods:Narrowing Beam Walking Test data from 40 prosthesis users was scored using recommended methods (i.e. average of trials 3–5) and conventional methods applied to other tests (i.e. mean or best of trials 1–3). Area under the receiver operating characteristic curve for each method was compared to 0.50, to determine if it was better than chance at identifying prosthesis-users with a history of falls, and to 0.80, to determine if it surpassed a threshold recommended for diagnostic accuracy.Results:Receiver operating characteristic curve area decreased when the Narrowing Beam Walking Test was scored using conventional rather than recommended procedures. Furthermore, when scored using conventional procedures, the NBWT no longer discriminated between prosthesis-users with and without a history of falls with a probability greater than chance, or exceeded recommended diagnostic thresholds.Conclusion:Scoring the Narrowing Beam Walking Test using conventional procedures that do not accommodate practice effects decreased its diagnostic accuracy among prosthesis-users relative to recommended procedures. Conventional scoring procedures may limit the effectiveness of performance-based tests used to screen for fall risk in prosthesis-users because they do not mitigate practice effects. The influence of practice effects on other tests, and test applications (e.g. clinical evaluation and prediction), is warranted.Clinical relevanceScoring a clinical balance test using conventional procedures that do not mitigate practice effects reduced its diagnostic accuracy. Changing administration and scoring procedures to accommodate practice effects should be considered to improve the diagnostic accuracy of other performance-based balance tests.

Bootstrap-based testing approaches for the assessment of the diagnostic accuracy of biomarkers subject to a limit of detection

2018 ◽  
Vol 28 (5) ◽  
pp. 1564-1578
Author(s):  
Alba M Franco-Pereira ◽  
Christos T Nakas ◽  
Alexander B Leichtle ◽  
M Carmen Pardo
Keyword(s):  
Diagnostic Accuracy ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Simulation Study ◽  
Operating Characteristic ◽  
Limit Of Detection ◽  
Characteristic Curve ◽  
Operating Characteristic Curve ◽  
Receiver Operating ◽  
Non Parametric

Assessment of the diagnostic accuracy of biomarkers through receiver operating characteristic curve analysis frequently involves a limit of detection imposed by the laboratory analytical system precision. As a consequence, measurements below a certain level are undetectable and ignoring these is known to lead to negatively biased estimates of the area under the receiver operating characteristic curve. In this article, we introduce two receiver operating characteristic curve-based parametric approaches that tackle the issue of correct assessment of diagnostic markers in the presence of a limit of detection. Proposed approaches are simulation-based utilising bootstrap methodology. Non-parametric alternatives that are naively used in the literature do not solve the inherent problem of limit of detection values which are treated as censored observations. However, the latter seems to perform adequately well in our simulation study. Nonparametric bootstrap was consistently used throughout, while other bootstrap alternatives performed similarly in our pilot simulation study. The simulation study involves the comparison of parametric and non-parametric options described here versus alternative strategies that are routinely used in the literature. We apply all methods to a study-setting resembling a chemical quasi-standard situation, where compound tumour biomarkers were searched within a multi-variable set of measurements to discriminate between two groups, namely colorectal cancer and controls. We focus in the assessment of glutamine and methionine.

scholarly journals TMA-93 for Diagnosing Amnestic Mild Cognitive Impairment: A Comparison With the Free and Cued Selective Reminding Test

2019 ◽  
Vol 34 (5) ◽  
pp. 322-328 ◽  
Author(s):  
Silvia Rodrigo-Herrero ◽  
Cristóbal Carnero-Pardo ◽  
Carlota Méndez-Barrio ◽  
Miguel De Miguel-Tristancho ◽  
Eugenia Graciani-Cantisán ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Characteristic Curve ◽  
First Grade ◽  
Evaluation Study ◽  
Amnestic Mild Cognitive Impairment ◽  
Selective Reminding ◽  
Selective Reminding Test ◽  
Normal Controls

Background:TMA-93 examines binding by images, an advantage for the less educated individuals.Aim:To compare the discriminative validity of TMA-93 against the picture version of Free and Cued Selective Reminding Test (FCSRT) to distinguish patients with amnestic mild cognitive impairment (aMCI) from normal controls (NCs) without excluding less educated individuals.Methods:Design:Phase I diagnostic evaluation study.Participants:A total of 30 patients with aMCI and 30 NCs matched for sociodemographics variables.Statistical Analysis:The diagnostic accuracy for each test was calculated by conducting receiver operating characteristic curve analysis. Hanley and McNeil method was used to compare diagnostic accuracy of different tests on the same sample.Results:Up to 41.7% of the sample had less than a first grade of education. Both tests showed excellent diagnostic accuracy. The comparisons did not show significant differences.Conclusions:TMA-93 is so accurate as FCSRT to differentiate aMCI from controls including less educated individuals. The test could be considered as a choice in this sociodemographic context.

scholarly journals Bootstrap-based procedures for inference in nonparametric receiver-operating characteristic curve regression analysis

2017 ◽  
Vol 27 (3) ◽  
pp. 740-764 ◽  
Author(s):  
María Xosé Rodríguez-Álvarez ◽  
Javier Roca-Pardiñas ◽  
Carmen Cadarso-Suárez ◽  
Pablo G Tahoces
Keyword(s):  
Diagnostic Accuracy ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Diagnostic System ◽  
R Package ◽  
Additive Models ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Prior to using a diagnostic test in a routine clinical setting, the rigorous evaluation of its diagnostic accuracy is essential. The receiver-operating characteristic curve is the measure of accuracy most widely used for continuous diagnostic tests. However, the possible impact of extra information about the patient (or even the environment) on diagnostic accuracy also needs to be assessed. In this paper, we focus on an estimator for the covariate-specific receiver-operating characteristic curve based on direct regression modelling and nonparametric smoothing techniques. This approach defines the class of generalised additive models for the receiver-operating characteristic curve. The main aim of the paper is to offer new inferential procedures for testing the effect of covariates on the conditional receiver-operating characteristic curve within the above-mentioned class. Specifically, two different bootstrap-based tests are suggested to check (a) the possible effect of continuous covariates on the receiver-operating characteristic curve and (b) the presence of factor-by-curve interaction terms. The validity of the proposed bootstrap-based procedures is supported by simulations. To facilitate the application of these new procedures in practice, an R-package, known as npROCRegression, is provided and briefly described. Finally, data derived from a computer-aided diagnostic system for the automatic detection of tumour masses in breast cancer is analysed.

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