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Title: Diagnostic accuracy, effectiveness and cost for cognitive impairment and dementia screening of three short cognitive tests applicable to illiterates
Authors: Carnero-Pardo, Cristóbal
Espejo-Martínez, Beatriz
López-Alcalde, Samuel
Espinosa-García, María
Sáez-Zea, Carmen
Hernández-Torres, Elisa
Navarro-Espigares, José Luis
Vílchez-Carrillo, Rosa
metadata.dc.contributor.authoraffiliation: [Carnero-Pardo,C; López-Alcalde,S; Espinosa-García,M; Sáez-Zea,C; Vílchez-Carrillo,R] Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, Spain. [Carnero-Pardo,C; Espinosa-García,M] FIDYAN Neurocenter, Granada, Spain. [Espejo-Martínez,B]Servicio de Neurología, Complejo Hospitalario La Mancha Centro, Alcázar de San Juan, Spain. [Sáez-Zea,C] Departamento de Psicología, Universidad de Jaén, Jaén, Spain. [Hernández-Torres,E; Navarro-Espigares,JL] Subdirección de Control de Gestión, Hospital Universitario Virgen de las Nieves, Granada, Spain.
Keywords: Anciano;Anciano de 80 o más Años;Trastornos del Conocimiento;Demencia;Escolaridad;Femenino;Humanos;Masculino;Mediana Edad;Sensibilidad y Especificidad;Anciano de 80 o más Años
metadata.dc.subject.mesh: Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged::Aged, 80 and over
Medical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Dementia
Medical Subject Headings::Health Care::Population Characteristics::Socioeconomic Factors::Educational Status
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Sensitivity and Specificity
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Medical Subject Headings::Psychiatry and Psychology::Mental Disorders::Delirium, Dementia, Amnestic, Cognitive Disorders::Cognition Disorders
Issue Date: 2-Nov-2011
Publisher: Public Library of Science
Citation: Carnero-Pardo C, Espejo-Martínez B, López-Alcalde S, Espinosa-García M, Sáez-Zea C, Hernández-Torres E et al. Diagnostic Accuracy, Effectiveness and Cost for Cognitive Impairment and Dementia Screening of Three Short Cognitive Tests Applicable to Illiterates. PLoS ONE 6(11): e27069
Abstract: BACKGROUND Illiteracy, a universal problem, limits the utilization of the most widely used short cognitive tests. Our objective was to assess and compare the effectiveness and cost for cognitive impairment (CI) and dementia (DEM) screening of three short cognitive tests applicable to illiterates. METHODS Phase III diagnostic test evaluation study was performed during one year in four Primary Care centers, prospectively including individuals with suspicion of CI or DEM. All underwent the Eurotest, Memory Alteration Test (M@T), and Phototest, applied in a balanced manner. Clinical, functional, and cognitive studies were independently performed in a blinded fashion in a Cognitive Behavioral Neurology Unit, and the gold standard diagnosis was established by consensus of expert neurologists on the basis of these results. Effectiveness of tests was assessed as the proportion of correct diagnoses (diagnostic accuracy [DA]) and the kappa index of concordance (k) with respect to gold standard diagnoses. Costs were based on public prices at the time and hospital accounts. RESULTS The study included 139 individuals: 47 with DEM, 36 with CI, and 56 without CI. No significant differences in effectiveness were found among the tests. For DEM screening: Eurotest (k = 0.71 [0.59-0.83], DA = 0.87 [0.80-0.92]), M@T (k = 0.72 [0.60-0.84], DA = 0.87 [0.80-0.92]), Phototest (k = 0.70 [0.57-0.82], DA = 0.86 [0.79-0.91]). For CI screening: Eurotest (k = 0.67 [0.55-0.79]; DA = 0.83 [0.76-0.89]), M@T (k = 0.52 [0.37-0.67]; DA = 0.80 [0.72-0.86]), Phototest (k = 0.59 [0.46-0.72]; DA = 0.79 [0.71-0.86]). There were no differences in the cost of DEM screening, but the cost of CI screening was significantly higher with M@T (330.7 ± 177.1 €, mean ± sd) than with Eurotest (294.1 ± 195.0 €) or Phototest (296.0 ± 196. 5 €). Application time was shorter with Phototest (2.8 ± 0.8 min) than with Eurotest (7.1 ± 1.8 min) or M@T (6.8 ± 2.2 min). CONCLUSIONS Eurotest, M@T, and Phototest are equally effective. Eurotest and Phototest are both less expensive options but Phototest is the most efficient, requiring the shortest application time.
Description: Journal Article; Research Support, Non-U.S. Gov't;
metadata.dc.identifier.doi: 10.1371/journal.pone.0027069
ISSN: 1932-6203 (Online)
Appears in Collections:01- Artículos - Hospital Virgen de las Nieves

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