scholarly journals External Validation of BMT-i Computerized Test Battery for Diagnosis of Learning Disabilities

2021 ◽  
Vol 9 ◽  
Author(s):  
Catherine Billard ◽  
Camille Jung ◽  
Arnold Munnich ◽  
Sahawanatou Gassama ◽  
Monique Touzin ◽  
...  
Keyword(s):  
Learning Disabilities ◽  
Executive Functioning ◽  
External Validation ◽  
Negative Likelihood Ratio ◽  
Test Battery ◽  
Cognitive Domain ◽  
Public Health Issue ◽  
Test Results ◽  
Reference Test ◽  
Great Cost

Background: Learning disabilities (LDs) are a major public health issue, affecting cognitive functions and academic performance for 8% of children. If LDs are not detected early and addressed through appropriate interventions, they have a heavy impact on these children in the social, educational, and professional spheres, at great cost to society. The BMT-i (Batterie Modulable de Tests informatisée, or “computerized Adaptable Test Battery”) enables fast, easy, reliable assessments for each cognitive domain. It has previously been validated in children ages 4–13 who had no prior complaints. The present study demonstrates the sensitivity of the BMT-i, relative to reference test batteries, for 191 children with cognitive difficulties.Materials and Methods: These 191 subjects were included in the study by the 14 pediatricians treating them for complaints in five cognitive domains: written language [60 (cases)]; mathematical cognition (40); oral language (60); handwriting, drawing, and visuospatial construction (45); and attention and executive functioning (45). In accordance with a predefined protocol, the children were administered BMT-i tests first, by their pediatricians, and reference tests later, by specialists to whom the BMT-i test results were not disclosed. Comparison of BMT-i and reference test results made it possible to evaluate sensitivity and agreement between tests.Results: For each of the five domains, the BMT-i was very sensitive (0.91–1), and normal BMT-i results were highly predictive of normal results for specialized reference tests [negative likelihood ratio (LR–): 0–0.16]. There was close agreement between BMT-i and reference tests in all domains except attention and executive functioning, for which only moderate agreement was observed.Conclusion: The BMT-i offers rapid, reliable, simple computerized assessments whose sensitivity and agreement with reference test batteries make it a suitable first-line instrument for LD screening in children 4–13 years old.

scholarly journals Development and Verification of a Deep Learning Algorithm to Evaluate Small-Bowel Preparation Quality

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1127
Author(s):  
Ji Hyung Nam ◽  
Dong Jun Oh ◽  
Sumin Lee ◽  
Hyun Joo Song ◽  
Yun Jeong Lim
Keyword(s):  
Deep Learning ◽  
Small Bowel ◽  
Scoring System ◽  
Operating Characteristic ◽  
Clinical Evidence ◽  
Learning Algorithm ◽  
Characteristic Curve ◽  
External Validation ◽  
Test Results ◽  
Deep Learning Algorithm

Capsule endoscopy (CE) quality control requires an objective scoring system to evaluate the preparation of the small bowel (SB). We propose a deep learning algorithm to calculate SB cleansing scores and verify the algorithm’s performance. A 5-point scoring system based on clarity of mucosal visualization was used to develop the deep learning algorithm (400,000 frames; 280,000 for training and 120,000 for testing). External validation was performed using additional CE cases (n = 50), and average cleansing scores (1.0 to 5.0) calculated using the algorithm were compared to clinical grades (A to C) assigned by clinicians. Test results obtained using 120,000 frames exhibited 93% accuracy. The separate CE case exhibited substantial agreement between the deep learning algorithm scores and clinicians’ assessments (Cohen’s kappa: 0.672). In the external validation, the cleansing score decreased with worsening clinical grade (scores of 3.9, 3.2, and 2.5 for grades A, B, and C, respectively, p < 0.001). Receiver operating characteristic curve analysis revealed that a cleansing score cut-off of 2.95 indicated clinically adequate preparation. This algorithm provides an objective and automated cleansing score for evaluating SB preparation for CE. The results of this study will serve as clinical evidence supporting the practical use of deep learning algorithms for evaluating SB preparation quality.

An Opinion on the Assessment of People Who May Have an Auditory Processing Disorder

2012 ◽  
Vol 23 (02) ◽  
pp. 097-105 ◽  
Author(s):  
Harvey Dillon ◽  
Sharon Cameron ◽  
Helen Glyde ◽  
Wayne Wilson ◽  
Dani Tomlin
Keyword(s):  
At Risk ◽  
Auditory Processing ◽  
Specific Form ◽  
Test Battery ◽  
Auditory Processing Disorder ◽  
Test Results ◽  
Hierarchical Approach ◽  
Clinical Efficiency ◽  
Impaired Ability ◽  
The Individual

We need to rethink how we assess auditory processing disorder (APD). The current use of test batteries, while necessary and well accepted, is at risk of failing as the size of these batteries increases. To counter the statistical, fatigue, and clinical efficiency problems of large test batteries, we propose a hierarchical approach to APD assessment. This begins with an overall test of listening difficulty in which performance is measurably affected for anyone with an impaired ability to understand speech in difficult listening conditions. It proceeds with a master test battery containing a small number of single tests, each of which assesses a different group of skills necessary for understanding speech in difficult listening conditions. It ends with a detailed test battery, where the individual tests administered from this battery are only those that differentiate the skills assessed by the failed test(s) from the master test battery, so that the specific form of APD can be diagnosed. An example of how hierarchical interpretation of test results could be performed is illustrated using the Listening in Spatialized Noise—Sentences test (LiSN-S). Although consideration of what abilities fall within the realm of auditory processing should remain an important issue for research, we argue that patients will be best served by focusing on whether they have difficulty understanding speech, identifying the specific characteristics of this difficulty, and specifically remediating and/or managing those characteristics.

scholarly journals Development and validation of a prognostic model for early triage of patients diagnosed with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chansik An ◽  
Hyun Cheol Oh ◽  
Jung Hyun Chang ◽  
Seung-Jin Oh ◽  
Jung Mo Lee ◽  
...  
Keyword(s):  
Prognostic Score ◽  
External Validation ◽  
Vital Signs ◽  
Underlying Disease ◽  
Test Results ◽  
Additional Information ◽  
Patient Will ◽  
National Cohort ◽  
Evaluation Metric ◽  
Development And Validation

AbstractWe developed a tool to guide decision-making for early triage of COVID-19 patients based on a predicted prognosis, using a Korean national cohort of 5,596 patients, and validated the developed tool with an external cohort of 445 patients treated in a single institution. Predictors chosen for our model were older age, male sex, subjective fever, dyspnea, altered consciousness, temperature ≥ 37.5 °C, heart rate ≥ 100 bpm, systolic blood pressure ≥ 160 mmHg, diabetes mellitus, heart disease, chronic kidney disease, cancer, dementia, anemia, leukocytosis, lymphocytopenia, and thrombocytopenia. In the external validation, when age, sex, symptoms, and underlying disease were used as predictors, the AUC used as an evaluation metric for our model’s performance was 0.850 in predicting whether a patient will require at least oxygen therapy and 0.833 in predicting whether a patient will need critical care or die from COVID-19. The AUCs improved to 0.871 and 0.864, respectively, when additional information on vital signs and blood test results were also used. In contrast, the protocols currently recommended in Korea showed AUCs less than 0.75. An application for calculating the prognostic score in COVID-19 patients based on the results of this study is presented on our website (https://nhimc.shinyapps.io/ih-psc/), where the results of the validation ongoing in our institution are periodically updated.

scholarly journals Test Accuracy of the Montreal Cognitive Assessment in Screening for Early Poststroke Neurocognitive Disorder

Stroke ◽  
2021 ◽  
Vol 52 (1) ◽  
pp. 317-320
Author(s):  
Ragnhild Munthe-Kaas ◽  
Stina Aam ◽  
Ingvild Saltvedt ◽  
Torgeir Bruun Wyller ◽  
Sarah T. Pendlebury ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Cognitive Assessment ◽  
Test Battery ◽  
Montreal Cognitive Assessment ◽  
Cognitive Domain ◽  
Cognitive Test ◽  
Test Accuracy ◽  
Neurocognitive Disorder ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual

Background and Purpose: We determined the diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for poststroke neurocognitive disorder defined according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria in a prospective observational study. Methods: Consecutive participants able to complete a cognitive test battery and MoCA 3 months poststroke were included. The reference standard of neurocognitive disorder was defined as a score of ≥1.5 SD below the normative mean in ≥1 cognitive domain on the cognitive test battery. Results: Among 521 participants (43.6% women; mean age/SD, 71.5/12.0 years; mean education/SD, 12.4/3.8 years), the area under the receiver operating characteristic curve of MoCA for neurocognitive disorder was 0.80 (95% CI, 0.76–0.84). Using the standard MoCA cutoff <26, sensitivity was 0.71 (0.69–0.79) with specificity of 0.73 (0.66–0.76). MoCA cutoff of <27 gave higher sensitivity (0.82 [0.77–0.85]) at the expense of specificity (0.60 [0.53–0.66]). Discussion: MoCA has reasonable accuracy for poststroke neurocognitive disorder diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02650531.

scholarly journals Subjectively and Objectively Measured Sleep Predict Differing Aspects of Cognitive Functioning in Adults

2019 ◽  
Vol 34 (7) ◽  
pp. 1127-1137 ◽  
Author(s):  
John P K Bernstein ◽  
Alyssa DeVito ◽  
Matthew Calamia
Keyword(s):  
Executive Functioning ◽  
Sleep Quality ◽  
Cognitive Functioning ◽  
Cognitive Domain ◽  
Subjective Sleep Quality ◽  
Cross Sectional ◽  
Subjective Sleep ◽  
Complex Cognition ◽  
Objectively Measured ◽  
Conceptual Flexibility

Abstract Objective To examine associations between subjectively-reported sleep and objectively-measured sleep (i.e., actigraphy) with different domains of cognitive functioning, and determine whether age may moderate these associations. Method In this cross-sectional study, a total of 489 participants (mean age = 45.4 years; SD = 18.8) completed a self-reported sleep measure and one week of actigraphy. Participants also completed a battery of cognitive tests measuring episodic memory, social cognition, executive functioning, and complex cognition (i.e., reasoning, visuospatial, and language abilities). Results Multiple regression analyses revealed that greater objective sleep quality and longer onset latencies were both associated with better performance on measures of conceptual flexibility. In contrast, subjective sleep quality was not associated with performance in any cognitive domain after accounting for objective sleep variables. Age moderated sleep–cognition relationships in differing ways based on cognitive domain and facet of sleep assessed. For example, whereas poorer subjective sleep quality was associated with poorer complex cognition in younger, but not older adults, poorer objective sleep quality was associated with poorer conceptual flexibility in older, but not younger adults. Conclusions Objectively-measured and self-reported sleep are associated with differing aspects of executive functioning, with the latter related to executive functioning broadly and the former associated with conceptual flexibility in particular. Age moderates sleep–cognition relationships differentially depending on the method by which sleep quality and quantity are measured.

Comparison of Two Tests of Visual-Motor Development Used to Assess Children with Learning Disabilities

1989 ◽  
Vol 68 (3_suppl) ◽  
pp. 1099-1103 ◽  
Author(s):  
Robert J. Palisano ◽  
Carol G. Dichter
Keyword(s):  
Learning Disabilities ◽  
Motor Skills ◽  
Motor Development ◽  
Motor Dysfunction ◽  
Test Results ◽  
Students With Learning Disabilities ◽  
Visual Motor Integration ◽  
Z Scores ◽  
Developmental Test ◽  
Visual Motor

To examine the validity and sensitivity of the Test of Visual-motor Skills and the Developmental Test of Visual-motor Integration, 38 students with learning disabilities were administered each test twice over a 6-mo. period. Correlations between age-equivalents, percentile ranks, and z-scores ranged from .58 to .71, supporting the construct validity of the Test of Visual-motor Skills. However, mean scores on the Developmental Test of Visual-motor Integration were significantly higher with all three methods of reporting test results and do not support concurrent validity. Subjects made a significantly greater mean change in age-equivalent score on the Test of Visual-motor Skills, suggesting that this score is preferable for measuring change in children receiving remedial programs for visual-motor dysfunction.

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