scholarly journals Performance of the Rowland Universal Dementia Assessment Scale for the Detection of Mild Cognitive Impairment and Dementia in a Diverse Cohort of Illiterate Persons From Rural Communities in Peru

2021 ◽  
Vol 12 ◽  
Author(s):  
Nilton Custodio ◽  
Rosa Montesinos ◽  
Monica M. Diaz ◽  
Eder Herrera-Perez ◽  
Kristhy Chavez ◽  
...  
Keyword(s):  
Rural Communities ◽  
Diagnostic Accuracy ◽  
Psychometric Properties ◽  
Gold Standard ◽  
Area Under The Curve ◽  
Assessment Scale ◽  
Screening Tools ◽  
Operating Characteristics ◽  
Clinical Dementia Rating ◽  
Optimal Cutoff

Background: The accurate diagnosis of neurocognitive disorders in illiterate Peruvian populations is challenging, largely owing to scarcity of brief cognitive screening tools (BCST) validated in these diverse populations. The Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) is a BCST that relies minimally on educational attainment and has shown good diagnostic accuracy in an urban illiterate population in Peru, yet its psychometric properties in illiterate populations in rural settings of the country have not been previously investigated.Objectives: To establish the diagnostic accuracy of the RUDAS-PE compared to expert clinical diagnosis using the Clinical Dementia Rating (CDR) Scale in healthy and cognitively impaired illiterate persons living in two culturally and geographically distinct rural communities of Peru.Methods: A cross-sectional, population-based study of residents ≥ 50 years of age living in the Peruvian rural communities of Santa Clotilde and Chuquibambilla. A total of 129 subjects (76 from Santa Clotilde and 53 from Chuquibambilla) were included in this study. Gold standard diagnostic neurocognitive evaluation was based on expert neurological history and examination and administration of the CDR. Receiver operating characteristics, areas under the curve (AUC), and logistic regression analyses were conducted to determine the performance of RUDAS-PE compared to expert gold standard diagnosis.Results: Compared to gold standard diagnosis, the RUDAS-PE was better at correctly discriminating between MCI and dementia than discriminating between MCI and controls in both sites (97.0% vs. 76.2% correct classification in Chuquibambilla; 90.0% vs. 64.7% in Santa Clotilde). In Chuquibambilla, the area under the curve (AUC) of the RUDAS to discriminate between dementia and MCI was 99.4% (optimal cutoff at <18), whereas between MCI and controls it was 82.8% (optimal cutoff at <22). In Santa Clotilde, the area under the curve (AUC) of the RUDAS to discriminate between dementia and MCI was 99.1% (optimal cutoff at <17), whereas between MCI and controls it was 75.5% (optimal cutoff at <21).Conclusions: The RUDAS-PE has acceptable psychometric properties and performed well in its ability to discriminate MCI and dementia in two cohorts of illiterate older adults from two distinct rural Peruvian communities.

scholarly journals Three versions of the Short Alcohol Dependence Data Questionnaire (SADD) in Mexican population: a comparative analysis of psychometric properties and diagnostic accuracy

Salud Mental ◽  
2015 ◽  
Vol 38 (4) ◽  
pp. 281-286
Author(s):  
Alejandro Pérez ◽  
◽  
Luis Villalobos-Gallegos ◽  
María del Carmen Viveros ◽  
Javier Graue ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Alcohol Dependence ◽  
Psychometric Properties ◽  
Addiction Treatment ◽  
Goodness Of Fit ◽  
Area Under The Curve ◽  
Reliability And Validity ◽  
Central Zone ◽  
Operating Characteristics ◽  
Good Reliability

Abstract Background. The Short Alcohol Dependence Data Questionnaire (SADD) has shown good reliability and validity in previous studies. In Mexico, although it is widely used in addiction treatment centers, little is known about its psychometric properties and diagnostic accuracy. Objective. Hence, this study performed a Confirmatory Factorial Analysis (CFA) on three SADD versions (15, 14 and 12 items) and examined their operating characteristics. Method. The sample included 570 individuals from the 30 Addiction Residential Centers localized in the central zone of Mexico. Results. The three versions showed an internal consistency of >.90, fair goodness-of-fit, and significant correlations with the Mini International Neuropsychiatric Interview (MINI) 5.0 Alcohol dependence (AD) diagnostic criteria. The analysis of the operating characteristics revealed that each version accounted for 84-85% of the area under the curve (AUC). Discussion and conclusion. The three SADD versions possess reliability and validity properties for the assessment of the alcohol dependence syndrome (ADS) and adequate diagnostic accuracy for the improvement of patients with AD in residential settings.

scholarly journals The role of red cell distribution width in the differential diagnosis of iron deficiency anemia and non-transfusion dependent thalassemia patients

2018 ◽  
Vol 10 (3) ◽  
Author(s):  
Pokpong Piriyakhuntorn ◽  
Adisak Tantiworawit ◽  
Thanawat Rattanathammethee ◽  
Chatree Chai-Adisaksopha ◽  
Ekarat Rattarittamrong ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Microcytic Anemia ◽  
Deficiency Anemia ◽  
Operating Characteristics ◽  
Training Set ◽  
Distribution Width ◽  
Validation Set ◽  
Sensitivity Specificity

This study aims to find the cut-off value and diagnostic accuracy of the use of RDW as initial investigation in enabling the differentiation between IDA and NTDT patients. Patients with microcytic anemia were enrolled in the training set and used to plot a receiving operating characteristics (ROC) curve to obtain the cut-off value of RDW. A second set of patients were included in the validation set and used to analyze the diagnostic accuracy. We recruited 94 IDA and 64 NTDT patients into the training set. The area under the curve of the ROC in the training set was 0.803. The best cut-off value of RDW in the diagnosis of NTDT was 21.0% with a sensitivity and specificity of 81.3% and 55.3% respectively. In the validation set, there were 34 IDA and 58 NTDT patients using the cut-off value of >21.0% to validate. The sensitivity, specificity, positive predictive value and negative predictive value were 84.5%, 70.6%, 83.1% and 72.7% respectively. We can therefore conclude that RDW >21.0% is useful in differentiating between IDA and NTDT patients with high diagnostic accuracy

scholarly journals Construct Validity and Psychometric Properties of the Tamil (India) Version of Montreal Cognitive Assessment (T-MoCA) in Elderly

2021 ◽  
Author(s):  
M Abdulkarim ◽  
J Venkatachalam
Keyword(s):  
Construct Validity ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Cognitive Assessment ◽  
Rating Scale ◽  
Area Under The Curve ◽  
Montreal Cognitive Assessment ◽  
Clinical Dementia Rating ◽  
Sensitivity Specificity ◽  
Test Retest Reliability

Background: The Montreal Cognitive Assessment (MoCA) is a neuropsychological cognitive tool developed and adapted widely in various languages for screening mild cognitive impairment (MCI). Objectives: The present study aimed to evaluate the psychometric properties of the Tamil (India) Version of MoCA (T-MoCA) and further examine the construct validity of the tool.Method: The authors conducted internal consistency, test-retest, sensitivity-specificity, and construct validity using 233 Tamil-speaking elderly participants. The inclusion criteria of the study participants were 0.5 or less than 0.5 scores in the Clinical Dementia Rating scale (CDR). Further, T-MoCA was used to screen MCI. Results: The result showed that the T-MoCA had high internal consistency (0.83) and high test-retest reliability (0.92). Receiver operating characteristic (ROC) analyses showed an area under the curve (AUC) of 0.91 (95% CI 0.87-0.94) for detecting MCI. Furthermore, the optimal cut-off score to detect MCI was 24, accommodated a sensitivity and specificity of 88.4% and 77.9%, respectively. Conclusions: The Tamil (India) version of the MoCA maintained its core diagnostic properties, furnishing it a valid and reliable tool for the screening of MCI. Also, its latent dimensions help to understand the elders’ cognitive function in a better way.

Diagnostic Accuracy of the AzBio Speech Recognition in Noise Test

2021 ◽  
pp. 1-14
Author(s):  
Andrew J. Vermiglio ◽  
Lauren Leclerc ◽  
Meagan Thornton ◽  
Hannah Osborne ◽  
Elizabeth Bonilla ◽  
...  
Keyword(s):  
Steady State ◽  
Speech Recognition ◽  
Diagnostic Accuracy ◽  
Signal To Noise Ratio ◽  
Area Under The Curve ◽  
Self Report ◽  
Reference Standard ◽  
Operating Characteristics ◽  
Noise Test ◽  
Speech Recognition In Noise

Purpose The goal of this study was to determine the ability of the AzBio speech recognition in noise (SRN) test to distinguish between groups of participants with and without a self-reported SRN disorder and a self-reported signal-to-noise ratio (SNR) loss. Method Fifty-four native English-speaking young adults with normal pure-tone thresholds (≤ 25 dB HL, 0.25–6.0 kHz) participated. Individuals who reported hearing difficulty in a noisy restaurant (Reference Standard 1) were placed in the SRN disorder group. SNR loss groups were created based on the self-report of the ability to hear Hearing in Noise Test (HINT) sentences in steady-state speech-shaped noise, four-talker babble, and 20-talker babble in a controlled listening environment (Reference Standard 2). Participants with HINT thresholds poorer than or equal to the median were assigned to the SNR loss group. Results The area under the curve from the receiver operating characteristics curves revealed that the AzBio test was not a significant predictor of an SRN disorder, or an SNR loss using the steady-state noise Reference Standard 2 condition. However, the AzBio was a significant predictor of an SNR loss using the four-talker babble and 20-talker babble Reference Standard 2 conditions ( p < .05). The AzBio was a significant predictor of an SNR loss when using the average HINT thresholds across the three Reference Standard 2 masker conditions (area under the curve = .79, p = .001). Conclusions The AzBio test was not a significant predictor of a self-reported SRN disorder or a self-reported SNR loss in steady-state noise. However, it was a significant predictor of a self-reported SNR loss in babble noise and the average across all noise conditions. A battery of reference standard tests with a range of maskers in a controlled listening environment is recommended for diagnostic accuracy evaluations of SRN tests.

scholarly journals Diagnostic accuracy of the iCare rebound tonometer compared to the Perkins applanation tonometer in assessing intraocular pressure in rural patients

Diagnosis ◽  
2015 ◽  
Vol 2 (4) ◽  
pp. 227-234 ◽  
Author(s):  
Yifan Li ◽  
Christopher R. Carpenter ◽  
Kathryn Nicholson ◽  
William Ken Milne
Keyword(s):  
Intraocular Pressure ◽  
Rural Communities ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Screening Tool ◽  
Unmet Need ◽  
Negative Likelihood Ratio ◽  
Rebound Tonometer ◽  
Applanation Tonometer ◽  
Icare Rebound Tonometer

AbstractVision health is recognized as a critical unmet need in North America. The ocular morbidity associated with glaucoma results from increased intraocular pressure (IOP) and early detection is crucial for the management of glaucoma. Our objective was to find a diagnostically accurate screening tool for intraocular hypertension that can be used in rural communities. We sought to validate the diagnostic accuracy of the iCare rebound tonometer against the gold standard Perkins applanation tonometer (PAT) in measuring IOP.Patients from two rural communities in Ontario, Canada visiting their optometrists for routine appointments had their IOP measured by a non-contact tonometer (NCT), an iCare rebound tonometer, and a Perkins applanation tonometer (PAT). Values of sensitivity, specificity, and likelihood ratios for a positive and negative result were calculated for the iCare and the NCT.Complete data was collected from 209 patients. Overall, the iCare tonometer had high levels of validity, as compared to the gold standard PAT. The iCare tonometer displayed excellent sensitivity of 98.3% (90–99%, 95% CI) and excellent negative likelihood ratio of 0.024 (0.0088–0.066, 95% CI) which is useful for ruling out intraocular hypertension.The iCare tonometer is a reasonably valid tool for detecting elevated IOP. Its ease of use, simplicity, and accessibility makes it a good screening tool to improve eye health in rural areas.

scholarly journals Accuracy of a 7-Item Patient-Reported Stand-Alone Tool for Periodontitis Screening

2021 ◽  
Vol 10 (2) ◽  
pp. 287
Author(s):  
Caroline Sekundo ◽  
Tobias Bölk ◽  
Olivier Kalmus ◽  
Stefan Listl
Keyword(s):  
Diagnostic Accuracy ◽  
Area Under The Curve ◽  
German Society ◽  
Screening Tools ◽  
University Hospital ◽  
Predictive Values ◽  
Periodontal Inflammation ◽  
Specificity And Sensitivity ◽  
Patient Reported ◽  
Sensitivity Specificity

Periodontitis is interrelated with various other chronic diseases. Recent evidence suggests that treatment of periodontitis improves glycemic control in diabetes patients and reduces the costs of diabetes treatment. So far, however, screening for periodontitis in non-dental settings has been complicated by a lack of easily applicable and reliable screening tools which can be applied by non-dental professionals. The purpose of this study was to assess the diagnostic accuracy of a short seven-item tool developed by the German Society for Periodontology (DG PARO) to screen for periodontitis by means of patient-reported information. A total of 88 adult patients filled in the patient-reported Periodontitis Risk Score (pPRS; range: 0 points = lowest periodontitis risk; 20 points = very high periodontitis risk) questionnaire before dental check-up at Heidelberg University Hospital. Subsequent clinical assessments according to Periodontal Screening and Recording (PSR®) were compared with pPRS scores. The diagnostic accuracy of pPRS at different cutoff values was assessed according to sensitivity, specificity, positive, and negative predictive values, as well as Receiver-Operator-Characteristic curves, Area Under the Curve (AUC), and logistic regression analysis. According to combined specificity and sensitivity (AUC = 0.86; 95%-CI: 0.76–0.95), the diagnostic accuracy of the pPRS for detecting periodontal inflammation (PSR® ≥ 3) was highest for a pPRS cutoff distinguishing between pPRS scores < 7 vs. ≥ 7. Patients with pPRS scores ≥ 7 had a 36.09 (95%-CI: 9.82–132.61) times higher chance of having a PSR® ≥ 3 than patients with scores < 7. In conclusion, the pPRS may be considered an appropriately accurate stand-alone tool for the screening for periodontitis.

scholarly journals Screening for Sleep Apnoea in Mild Cognitive Impairment: The Utility of the Multivariable Apnoea Prediction Index

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Georgina Wilson ◽  
Zoe Terpening ◽  
Keith Wong ◽  
Ron Grunstein ◽  
Louisa Norrie ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Roc Curve ◽  
Area Under The Curve ◽  
Sleep Apnoea ◽  
Self Report ◽  
Screening Tools ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Obstructive Sleep

Purpose. Mild cognitive impairment (MCI) is considered an “at risk” state for dementia and efforts are needed to target modifiable risk factors, of which Obstructive sleep apnoea (OSA) is one. This study aims to evaluate the predictive utility of the multivariate apnoea prediction index (MAPI), a patient self-report survey, to assess OSA in MCI.Methods. Thirty-seven participants with MCI and 37 age-matched controls completed the MAPI and underwent polysomnography (PSG). Correlations were used to compare the MAPI and PSG measures including oxygen desaturation index and apnoea-hypopnoea index (AHI). Receiver-operating characteristics (ROC) curve analyses were performed using various cut-off scores for apnoea severity.Results. In controls, there was a significant moderate correlation between higher MAPI scores and more severe apnoea (AHI:r=0.47,P=0.017). However, this relationship was not significant in the MCI sample. ROC curve analysis indicated much lower area under the curve (AUC) in the MCI sample compared to the controls across all AHI severity cut-off scores.Conclusions. In older people, the MAPI moderately correlates with AHI severity but only in those who are cognitively intact. Development of further screening tools is required in order to accurately screen for OSA in MCI.

scholarly journals Evaluation of the Brazilian version of Patient Health Questionnaire (PHQ-9) in Quilombola population using the Item Response Theory

Salud Mental ◽  
2019 ◽  
Vol 42 (1) ◽  
pp. 43-50
Author(s):  
Sabrina Martins Barroso ◽  
Ana Paula Souto Melo ◽  
Mônia Aparecida da Silva ◽  
Mark Drew Crosland Guimarães
Keyword(s):  
Item Response Theory ◽  
Rural Communities ◽  
Psychometric Properties ◽  
Item Response ◽  
Screening Tools ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Response Theory ◽  
Patient Health ◽  
Depressive Episodes

Introduction. The Patient Health Questionnaire (PHQ-9) is one of the most validated tools used to detect depressive episodes in Brazil. Objective. This study investigates the psychometric properties of the PHQ-9 using the Item Response Theory. Method. We used the gradual response model to assess depression in 764 residents of Brazilian rural communities of descended from slaves (quilombos) from the county of Vitória da Conquista, state of Bahia, Brazil, who had responded to PHQ-9. We estimated the parameters for item discrimination and difficulty. Results. The items of the PHQ-9 showed the ability to discriminate from moderate to very high. The items evaluating thoughts of hurting oneself and death showed the greatest discrimination while feeling depressed showed the lowest discrimination. Discussion and conclusion. The Item Response Theory enables advances in the analysis of the psychometric properties of the screening tools assessing depression, and indicates that PHQ-9 can be used in rural populations in Brazil.

scholarly journals Determining Appropriate Screening Tools and Cutoffs for Cognitive Impairment in the Chinese Elderly

2021 ◽  
Vol 12 ◽  
Author(s):  
Shaowei Zhang ◽  
Qi Qiu ◽  
Shixing Qian ◽  
Xiang Lin ◽  
Feng Yan ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Area Under The Curve ◽  
Screening Tools ◽  
Optimal Cutoff ◽  
Chinese Elderly ◽  
Elderly Individuals ◽  
Highly Educated ◽  
Dementia Patients ◽  
Education Levels ◽  
Cutoff Scores

Background: The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are the most commonly used tools for cognitive impairment screening. The present study aimed to investigate the ability of the MOCA and MMSE to differentiate between cognitively normal elderly individuals, MCI patients and dementia patients at different ages and education levels and to establish the optimal cutoff scores of the MoCA and MMSE for MCI and dementia in the Chinese elderly.Methods: A total of 2,954 Chinese elderly individuals, including 1,746 normal controls, 599 MCI patients and 249 dementia patients, were consecutively recruited in the study. The optimal cutoffs for MoCA and MMSE were determined using receiver operating characteristic (ROC) analysis among the different age and education levels in the three groups. Furthermore, comparison of ROC curves were made to evaluate the performances of the two tests.Results: The area under the curve(AUC) of the MoCA (0.82) for detecting MCI was significantly higher than that of the MMSE (0.75) (P &lt; 0.001). When the sample was divided according to age and education level, the AUC of the MoCA (0.84) was higher than those of the MMSE (0.71) for MCI (P &lt; 0.001) in the younger and more highly-educated groups. The optimal cutoff scores of the MoCA for the groups aged ≤ 75 years old and education ≤ 6 years, aged &gt; 75 years old and education ≤ 6 years, aged ≤ 75 years old and education &gt; 6 years, aged &gt; 75 years old and education &gt; 6 years in screening for MCI were identified as 19.5, 15.5, 24.5 and 24.5, respectively, and the optimal cutoff scores for dementia were 18.5, 10.5, 18.5 and 20.5, respectively. For MMSE in the above four groups, the cutoff scores to detect MCI were 26.5, 22.5, 28.5 and 26.5, respectively, and the optimal cutoff scores for dementia were 23.5, 19.5, 23.5 and 23.5, respectively.Conclusion: Compared to MMSE, the MoCA is more suitable for discriminating MCI in younger and more highly educated elderly Chinese individuals. However, the MMSE has advantage over MoCA in screening MCI in individuals with lower education levels and the older groups of Chinese elderly.

scholarly journals Circulating miRNA as Biomarkers for Colorectal Cancer Diagnosis and Liver Metastasis

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 341
Author(s):  
Farah J. Nassar ◽  
Zahraa S. Msheik ◽  
Maha M. Itani ◽  
Remie El Helou ◽  
Ruba Hadla ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastasis ◽  
Diagnostic Accuracy ◽  
Area Under The Curve ◽  
Stage Iv ◽  
Screening Tests ◽  
Operating Characteristics ◽  
Diagnostic Biomarkers ◽  
Circulating Mirna ◽  
Non Invasive

Colorectal cancer (CRC) is the second leading cause of cancer deaths worldwide. Stage IV CRC patients have poor prognosis with a five-year survival rate of 14%. Liver metastasis is the main cause of mortality in CRC patients. Since current screening tests have several drawbacks, effective stable non-invasive biomarkers such as microRNA (miRNA) are needed. We aim to investigate the expression of miRNA (miR-21, miR-19a, miR-23a, miR-29a, miR-145, miR-203, miR-155, miR-210, miR-31, and miR-345) in the plasma of 62 Lebanese Stage IV CRC patients and 44 healthy subjects using RT-qPCR, as well as to evaluate their potential for diagnosis of advanced CRC and its liver metastasis using the Receiver Operating Characteristics (ROC) curve. miR-21, miR-145, miR-203, miR-155, miR-210, miR-31, and miR-345 were significantly upregulated in the plasma of surgery naïve CRC patients when compared to healthy individuals. We identified two panels of miRNA that could be used for diagnosis of Stage IV CRC (miR-21 and miR-210) with an area under the curve (AUC) of 0.731 and diagnostic accuracy of 69% and liver metastasis (miR-210 and miR-203) with an AUC = 0.833 and diagnostic accuracy of 72%. Panels of specific circulating miRNA, which require further validation, could be potential non-invasive diagnostic biomarkers for CRC and liver metastasis.

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