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摘要
目的:本研究的主要目的是确定时钟绘图测试(CDT)在检测可能的痴呆方面的准确性,灵敏度和特异性,与多域痴呆筛查测试DemTect相比。 方法:样本来源于全科医师(GP)为基础,集群随机对照干预试验DelpHi-MV(痴呆:梅克伦堡 - 前波美拉尼亚的生活和以人为中心的帮助)。从6.440名患者中选择初级保健系统筛查痴呆,我们检查了三组(a,b,c)CDT(作为指标测试)以及DemTect(作为参考标准)。在排除缺失值的病例后,我们纳入了一个样本n = 462与“可能的痴呆”,n = 586与“轻度认知功能障碍”和n = 553与“无认知障碍”匹配的年龄和性别。我们通过DemTect分析了CDT在识别可能发生痴呆的人中的准确性,并报告了CDT的敏感性和特异性。我们进一步分析了与这些群体相关的年龄和性别差异。 结果:与DemTect相比,CDT发现筛查患者比认知障碍者多两倍(CDT患者63.1%,DemTect患者为28.9%)。 CDT的敏感性和特异性分别为84.4%和45.6%。我们发现CDT的表现有相当的年龄和性别差异。更高的年龄(p <0.001)和女性(p <0.001)与不正确的时钟绘图有关。 结论:与DemTect相比,CDT显示出相当高的假阳性筛查结果率,并且不利于老年人和女性。因此,与以前的研究结果相反,我们的研究结果表明CDT不应该被用作筛查初级保健中可能的痴呆的独家仪器。
关键词: 时钟绘图测试,可能的痴呆,筛选仪器,初级保健,DelpHi-MV,DemTect。
Current Alzheimer Research
Title:The Clock Drawing Test: A Reasonable Instrument to Assess Probable Dementia in Primary Care?
Volume: 15 Issue: 1
关键词: 时钟绘图测试,可能的痴呆,筛选仪器,初级保健,DelpHi-MV,DemTect。
摘要: Objective: The primary aim of the study was to determine accuracy, sensitivity and specificity of the Clock Drawing Test (CDT) in detecting probable dementia as compared to the multi-domain dementia screening test DemTect.
Methods: The sample was derived from the general practitioner (GP)-based, cluster-randomized controlled intervention trial DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania). Selected from 6.440 patients systematically screened for dementia in primary care, we examined three groups (a,b,c) where the CDT (as index test) as well as the DemTect (as reference standard) were available. After excluding cases with missing values, we included a sample of n=462 with “probable dementia”, n=586 with “mild cognitive impairment” and n=553 with “no cognitive impairment” matched for age and gender. We analyzed the accuracy of the CDT in identifying people with probable dementia by the DemTect and report sensitivity, and specificity for the CDT. We further analyzed age and gender differences associated with the groups.
Results: In comparison to the DemTect the CDT identified more than twice as many of the screened patients as cognitively impaired (63.1% in the CDT vs. 28.9% in the DemTect). The sensitivity and specificity for the CDT were 84.4% and 45.6% respectively. We found considerable age and gender differences for the performance of the CDT. Higher age (p < 0.001) and female sex (p < 0.001) were associated with incorrect clock drawings.
Conclusion: The CDT shows a considerably high rate of false positive screening outcomes compared to the DemTect and disadvantages older people and women. Thus, in contrary to previous findings our results indicate that the CDT should not be used as exclusive instrument to screen for probable dementia in primary care.
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Cite this article as:
The Clock Drawing Test: A Reasonable Instrument to Assess Probable Dementia in Primary Care?, Current Alzheimer Research 2018; 15 (1) . https://dx.doi.org/10.2174/1567205014666170908101822
DOI https://dx.doi.org/10.2174/1567205014666170908101822 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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