scholarly journals Current Update on the Clinical Utility of MMSE and MoCA for Stroke Patients in Asia: A Systematic Review

2021 ◽  
Vol 18 (17) ◽  
pp. 8962
Author(s):  
Julia Khaw ◽  
Ponnusamy Subramaniam ◽  
Noor Azah Abd Aziz ◽  
Azman Ali Raymond ◽  
Wan Asyraf Wan Zaidi ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Clinical Utility ◽  
Education Level ◽  
Cutoff Score ◽  
Detection Accuracy ◽  
Stroke Patients ◽  
Clinical Value ◽  
Verbal Abilities ◽  
Primary Care Clinicians ◽  
Practice Methods

Objective: Primary care clinicians in Asia employed the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) to aid dementia diagnosis post-stroke. Recent studies questioned their clinical utility in stroke settings for relying on verbal abilities and education level, as well as lack of consideration for aphasia and neglect. We aimed to review the clinical utility of the MMSE and MoCA for stroke patients in Asia and provide recommendations for clinical practice. Methods: PubMed, Scopus, Web of Science, and Science Direct were searched for relevant articles. Included studies were assessed for risk of bias. RevMan 5.4 was used for data synthesis (sensitivity and specificity) and covariates were identified. Results: Among the 48 full-text articles reviewed, 11 studies were included with 3735 total subjects; of these studies, 7 (77%) were conducted in China, 3 (27%) in Singapore, and 1 (9%) in South Korea. Both the MMSE and MoCA generally showed adequate sensitivity and specificity. Education was identified as a covariate that significantly affected detection accuracy. Due to heterogeneity in cutoff scores, methodologies, and languages, it was not feasible to suggest a single cutoff score. One additional point is recommended for MoCA for patients with <6 years of education. Conclusion: Clinicians in Asia are strongly recommended to consider the education level of stroke patients when interpreting the results of the MMSE and MoCA. Further studies in other Asian countries are needed to understand their clinical value in stroke settings.

The Four-Point Scoring System for the Clock Drawing Test Does Not Differentiate between Alzheimer's Disease and Vascular Dementia

2010 ◽  
Vol 106 (3) ◽  
pp. 941-948 ◽  
Author(s):  
April R. Wiechmann ◽  
James R. Hall ◽  
Sid O'bryant
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vascular Dementia ◽  
Sensitivity And Specificity ◽  
Scoring System ◽  
Cutoff Score ◽  
Characteristic Analysis ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test

The purpose of this study was to explore the sensitivity and specificity of the Clock Drawing Test by using a widely employed four-point scoring system to discriminate between patients with Alzheimer's disease or vascular dementia. Receiver operating characteristic analysis indicated that the Clock Drawing Test was able to distinguish between normal elders and those with a dementia diagnosis. The cutoff score for differentiating patients with Alzheimer's disease from normal participants was = 3. The cutoff score for differentiating those with vascular disease from normal participants was = 3. Overall, the four-point scoring system demonstrated good sensitivity and specificity for identifying cognitive dysfunction associated with dementia; however, the current findings do not support the utility of the four-point scoring system in discriminating Alzheimer's disease and vascular dementia.

The type—token ratio in schizophrenic disorders: clinical and research value

1984 ◽  
Vol 14 (1) ◽  
pp. 151-157 ◽  
Author(s):  
Theo C. Manschreck ◽  
Brendan A. Maher ◽  
Toni M. Hoover ◽  
Donna Ames
Keyword(s):  
Sensitivity And Specificity ◽  
Spoken Language ◽  
Thought Disorder ◽  
Clinical Value ◽  
Clinical Sensitivity ◽  
Normal Controls

SynopsisPrior research has indicated that the type-token ratio (TTR), a measure of repetition in language, correlates with clinical judgements of thought disorder when spoken language was examined, and differentiates statistically thought-disordered from non-thought-disordered schizophrenics and psychiatric and normal controls. We replicated this finding and examined the clinical sensitivity and specificity of the TTR measure in the diagnosis and in the assessment of thought disorder. The current clinical value of the TTR is limited, but further investigations of the nature of repetition in schizophrenic language are warranted.

Psychometric Properties of the Dutch Version of the Signs of Depression Scale

2016 ◽  
Vol 27 (5) ◽  
pp. 617-637 ◽  
Author(s):  
Mariska J. van Dijk ◽  
Janneke M. de Man-van Ginkel ◽  
Thóra B. Hafsteinsdóttir ◽  
Marieke J. Schuurmans
Keyword(s):  
Psychometric Properties ◽  
Intraclass Correlation ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Cutoff Score ◽  
Stroke Patients ◽  
Dutch Version ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
Patient Health

The early detection of depression after stroke is essential for the optimization of recovery in aphasic stroke patients. The purpose of this study was to evaluate the psychometric properties of the Signs of Depression Scale (SODS), a non-language-based screening instrument. We conducted a cross-sectional study in a sample of 58 stroke patients in a rehabilitation center. The internal consistency and interrater reliability were good (α = .71 and intraclass correlation coefficient [ICC] = .79). The pre-defined hypotheses confirmed the construct validity, and the correlation between the SODS and the Patient Health Questionnaire–9 (PHQ-9) was moderate ( rb = .32). At a cutoff score of ≥1, the sensitivity was 0.80, and the specificity was 0.39. These findings indicate that the SODS is appropriate to screen for depressive symptoms and can be used by nurses to identify symptoms of depression in patients with aphasia who require further assessment.

scholarly journals Faktor-faktor yang Berhubungan dengan Keterlambatan Kedatangan Pasien Stroke di RSUP Prof. Dr. R. D. Kandou Manado

e-CliniC ◽  
2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Derrel V. Barahama ◽  
Gilbert Tangkudung ◽  
Mieke A. H. N. Kembuan
Keyword(s):  
Medical Treatment ◽  
Sampling Technique ◽  
Educational Status ◽  
Education Level ◽  
Stroke Patients ◽  
Stroke Event ◽  
Chi Square ◽  
Purposive Sampling ◽  
Late Arrival ◽  
Minimum Number

Abstract: Stroke is a global health problem. Ensuring the arrival of patients to the hospital to get medical treatment in a timely manner is vital in a stroke event. The late arrival of stroke patients at the hospital is the main reason for delayed medical treatment. Age, gender, education level, site of residence, distance of residence, and ambulance usage are some of the factors associated with the late arrival of stroke patients to the hospital. This study was aimed to determine the relationship between age, gender, educational status, distance of residence, residence site, as well as ambulance usage and the late arrival of stroke patients at Prof. Dr. R. D. Kandou Hospital Manado. This was an analytical retrospective study using patients’ medical record data. Samples were obtained by using purposive sampling technique with a minimum number of 226 samples. Data were analyzed by using the chi-square test which showed that of the 231 samples the P values were, as follows: age (P=0.711), gender (P=0.879), education level (P=0.010), residence site (P=0.303), distance of residence (P=0.458), and ambulance usage (P=0.469). Conclusion: There was a significant association between education level and the late arrival of stroke patients at Prof. R. D. Kandou Hospital Manado.Keywords: stroke, late arrivalAbstrak: Stroke merupakan masalah kesehatan global. Memastikan kedatangan pasien ke rumah sakit untuk mendapatkan penanganan medis secara tepat waktu merupakan hal yang vital pada suatu kejadian stroke. Keterlambatan kedatangan pada pasien stroke sebelum tiba di rumah sakit merupakan alasan utama terjadinya keterlambatan penanganan medis pada kasus stroke. Usia, jenis kelamin, tingkat pendidikan, jarak tempat tinggal, letak tempat tinggal dan pengguanaan ambulans merupakan beberapa faktor yang berhubungan dengan keterlambatan kedatangan pasien stroke ke rumah sakit. Penelitian ini bertujuan untuk mengetahui hubungan antara usia, jenis kelamin, tingkat pendidikan, letak tempat tinggal, jarak tempat tinggal dan penggunaan ambulans dengan keterlambatan kedatangan pasien stroke di RSUP Prof. dr. R. D. Kandou Manado. Jenis penelitian ialah analitik retrospektif menggunakan data rekam medik pasien. Metode pengambilan sampel menggunakan teknik purposive sampling dengan jumlah minimal 226 sampel yang memenuhi kriteria penelitian. Hasil uji chi-square dari 231 sampel mendapatkan nilai P sebagai berikut: usia (P=0,711), jenis kelamin (P=0,879), tingkat pendidikan (P=0,010), letak tempat tinggal (P=0,303), jarak tempat tinggal (P=0,458) dan penggunaan ambulans (P=0,469). Simpulan: Terdapat hubungan bermakna antara tingkat pendidikan dengan keterlambatan kedatangan pasien stroke di RSUP Prof. R. D. Kandou ManadoKata kunci: stroke, keterlambatan kedatangan

scholarly journals Comparing Sensitivity and Specificity of Addenbrooke’s Cognitive Examination-I, III and Mini-Addenbrooke’s Cognitive Examination in Parkinson’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Tivadar Lucza ◽  
Zsuzsanna Ascherman ◽  
Márton Kovács ◽  
Attila Makkos ◽  
Márk Harmat ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sensitivity And Specificity ◽  
Neurodegenerative Disorder ◽  
Education Level ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Receiver Operation Characteristic ◽  
Education Levels ◽  
Addenbrooke’S Cognitive Examination

Background. Parkinson’s disease (PD) is the second most common neurodegenerative disorder characterized by numerous motor and nonmotor symptoms. Neurocognitive disorders (NCD) are one of the most troublesome problems and their diagnosis is often challenging. Methods. We compared the sensitivity and specificity of several versions of Addenbrooke Cognitive Examination (ACE, ACE-III, and Mini-ACE) on 552 subjects with PD. Normal cognition, mild and major NCD were judged in accordance with the respective criteria of the Diagnostic and Statistical Manual of Mental Disorders 5th edition. Subsequently, we applied the receiver operation characteristic (ROC) analysis in comparison of different education levels. Results. For subjects with education level 0–8 and 9–12 years, the ACE-III had the best discriminating capabilities for mild NCD (cut-off scores: 83.5 and 85.5 points, respectively), while Mini-ACE was the best for subjects having education > 12 years (cut-off score: 25.5 points). For detecting major NCD, ACE-III had the best diagnostic accuracy in all levels of education (cut-off scores: 70.5, 77.5, and 78.5 points for subjects having education level 0–8, 9–12, and >12 years, respectively). Conclusion. ACE-III and its nested version, the Mini-ACE, had the best screening abilities for detecting mild and major NCD in PD.

Lung Ultrasound Findings Compared to Chest CT Scan in Patients with COVID-19 Associated Pneumonia: A Pilot Study

2021 ◽  
Author(s):  
Hamidreza Hatamabadi ◽  
Majid Shojaee ◽  
Mohammad Bagheri ◽  
Masoomeh Raoufi
Keyword(s):  
Pilot Study ◽  
Ct Scan ◽  
Sensitivity And Specificity ◽  
Lung Ultrasound ◽  
Demographic Data ◽  
Ground Glass Opacity ◽  
Chest Ct ◽  
Clinical Value ◽  
Ultrasound Evaluation ◽  
Chest Ct Scan

Introduction: Lung US has been reported to be as useful as a chest CT scan and much better than a chest x-ray for the evaluation of pneumonia. Objective: This study aimed to compare the findings of lung ultrasound (US) and chest CT scan of patients with COVID-19-associated pneumonia in the Emergency Department (ED). Methods: This retrospective observational pilot study was carried out on confirmed COVID-19 patients in the isolation corona ward of the Imam Hussein Hospital ED from March 15 to March 22, 2020. After obtaining demographic data, the patients underwent a pulmonary bedside US examination, with the patients in the sitting position, turning their back to the examiner. A 10-point lung US was performed. Each lung was divided into two areas: posterior (three zones) and lateral (two zones). The patients’ lung ultrasound and chest CT scan as the standard imaging were blindly reviewed and recorded. The clinical value of ultrasound was evaluated with different severity of lung involvement according to CT severity score. Results: Nineteen patients (38 zones), including 13 males, were evaluated with a mean age of 62.5±16.8 years. B2 lines and consolidation observed in the US examinations were significantly correlated with ground-glass opacity and consolidation observed in CT scan examinations, respectively (p <0.0001). US sensitivity and specificity of finding B2 lines were 90% and 100%, respectively. Also, the sensitivity and specificity of US in identifying consolidation were 82% and 100%, respectively. In the lungs with moderate and severe lobar involvement, US findings were significantly correlated (p <0.05) with CT scan findings. Conclusions: Ultrasound evaluation is a safe, fast, and rapid technique for the evaluation of patients with moderate to severe COVID-19-associated pneumonia. It is a reproducible procedure and can be implemented by the operator after a short course of training.

Clinical utility of biochemical analysis of cerebrospinal fluid

1995 ◽  
Vol 41 (3) ◽  
pp. 343-360 ◽  
Author(s):  
M A Watson ◽  
M G Scott
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Utility ◽  
Biochemical Analysis ◽  
Clinical Chemistry ◽  
Chemistry Laboratory ◽  
Microbial Culture ◽  
Clinical Use ◽  
Clinical Value ◽  
Clinical Chemistry Laboratory ◽  
Biochemical Measurements

Abstract In addition to microbial culture, cytology, and immunological studies, physicians rely on the clinical chemistry laboratory for biochemical analysis of patients' cerebrospinal fluid (CSF). However, apart from routine glucose and protein determinations, the clinical value of other CSF analytes is often unclear. Here, we review the literature pertaining to the use of CSF biochemical measurements in managing patients with infectious disease, neoplasia, stroke and trauma, and dementia. Although a small number of studies demonstrate potential usefulness of some markers, we conclude that, without further study, the data are insufficient to support the routine clinical use of most of the analytes examined.

scholarly journals LO76: Can emergency physicians perform carotid artery ultrasound to detect severe stenosis in patients with TIA and stroke?

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S34-S34
Author(s):  
R. Suttie ◽  
M.Y. Woo ◽  
J.J. Perry ◽  
L. Park ◽  
G. Stotts
Keyword(s):  
Carotid Artery ◽  
Sensitivity And Specificity ◽  
Tertiary Care ◽  
Stroke Patients ◽  
Convenience Sample ◽  
Test Characteristics ◽  
Urgent Surgery ◽  
Ica Stenosis ◽  
Mean Time ◽  
Rule Out

Introduction: Carotid artery stenosis (CAS) is a common cause of stroke. Patients with severe, symptomatic CAS can have their subsequent stroke risk reduced by carotid endarterectomy or stenting when completed soon after a TIA or non-disabling stroke. Patients presenting to a peripheral ED with TIA/stroke, may require transfer to another hospital for imaging to rule-out CAS. The purpose of this study was to determine the test characteristics of carotid artery POCUS in detecting greater than 50% stenosis in patients presenting with TIA/stroke. Methods: We conducted a prospective cohort study on a convenience sample of adult patients presenting to a tertiary care academic ED with TIA/stroke between June and October 2017. Carotid POCUS was performed by a trained medical student or a trained emergency physician. Our outcome measure, CAS >50% was determined by the final radiology report of CTA imaging by a trained radiologist, blinded to our study. A blinded POCUS expert reviewed the carotid POCUS scans. We calculated the sensitivity and specificity for CAS >50% using carotid POCUS versus the gold standard of CTA. Results: We enrolled 75 patients of which 5 did not meet inclusion criteria. The mean age was 70.4 years, 57% were male. 16% were diagnosed with greater than 50% CAS. 47% were stroke codes and 37% were admitted to hospital. Carotid POCUS had a sensitivity and specificity of 72% (46%-99%) and 88% (80%-96%) respectively. There were three false negatives of which two were exactly 50% ICA stenosis on CTA and the other was 100% occlusion of the distal ICA. Kappa coefficient for inter-rater reliability between standard and expert interpretation was 0.68 for moderate agreement. The scan took a mean time of 6.2 minutes to complete. Conclusion: Carotid POCUS has moderate correlation with CTA for detection of CAS greater than 50%. Carotid POCUS identified all the critical 70-99% stenosis lesions that would need urgent surgery. Further research is needed to confirm these findings.

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