Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/642
Title: Effectiveness and costs of phototest in dementia and cognitive impairment screening
Authors: Carnero-Pardo, Cristobal
Espejo-Martinez, Beatriz
Lopez-Alcalde, Samuel
Espinosa-Garcia, Maria
Saez-Zea, Carmen
Vilchez-Carrillo, Rosa
Hernandez-Torres, Elisa
Navarro-Espigares, Jose L
metadata.dc.contributor.authoraffiliation: [Carnero-Pardo,C; Lopez-Alcalde,S; Espinosa-Garcia,M; Saez-Zea,C; Vilchez-Carrillo,R] Cognitive Behavioral Neurology Unit, Service of Neurology, Virgen de las Nieves University Hospital, Granada, Spain. [ Carnero-Pardo,C; Espinosa-Garcia,M] FIDYAN Neurocenter, Granada, Spain. [Espejo-Martinez,B] Service of Neurology, La Mancha Center Hospital Complex, Alcazar de San Juan, Ciudad Real, Spain. [Saez-Zea,C] Departament of Psychobiology, School of Psychology, University of Jaen, Jaen, Spain. [Hernandez-Torres,E; Navarro-Espigares,JL] Management Control Section, Virgen de las Nieves University Hospital,Granada, Spain.
Keywords: Trastornos del Conocimiento;Demencia;Femenino;Humanos;Masculino;Tamizaje Masivo;Pruebas Neuropsicológicas;Anciano;Ancianos 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::Psychiatry and Psychology::Mental Disorders::Delirium, Dementia, Amnestic, Cognitive Disorders::Cognition Disorders
Medical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Dementia
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Mass Screening
Medical Subject Headings::Psychiatry and Psychology::Behavioral Disciplines and Activities::Psychological Tests::Neuropsychological Tests
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Issue Date: 9-Jul-2011
Publisher: BioMed Central
Citation: Carnero-Pardo C, Espejo-Martinez B, Lopez-Alcalde S, Espinosa-Garcia M , Saez-Zea C, Vilchez-Carrillo R et al. Effectiveness and costs of phototest in dementia and cognitive impairment screening. BMC Neurol. 2011 Jul 29;11:92.
Abstract: BACKGROUND To assess and compare the effectiveness and costs of Phototest, Mini Mental State Examination (MMSE), and Memory Impairment Screen (MIS) to screen for dementia (DEM) and cognitive impairment (CI). METHODS A phase III study was conducted over one year in consecutive patients with suspicion of CI or DEM at four Primary Care (PC) centers. After undergoing all screening tests at the PC center, participants were extensively evaluated by researchers blinded to screening test results in a Cognitive-Behavioral Neurology Unit (CBNU). The gold standard diagnosis was established by consensus of expert neurologists. Effectiveness was assessed by the proportion of correct diagnoses (diagnostic accuracy [DA]) and by the kappa index of concordance between test results and gold standard diagnoses. Costs were based on public prices and hospital accounts. RESULTS The study included 140 subjects (48 with DEM, 37 with CI without DEM, and 55 without CI). The MIS could not be applied to 23 illiterate subjects (16.4%). For DEM, the maximum effectiveness of the MMSE was obtained with different cutoff points as a function of educational level [k = 0.31 (95% Confidence interval [95%CI], 0.19-0.43), DA = 0.60 (95%CI, 0.52-0.68)], and that of the MIS with a cutoff of 3/4 [k = 0.63 (95%CI, 0.48-0.78), DA = 0.83 (95%CI, 0.80-0.92)]. Effectiveness of the Phototest [k = 0.71 (95%CI, 0.59-0.83), DA = 0.87 (95%CI, 0.80-0.92)] was similar to that of the MIS and higher than that of the MMSE. Costs were higher with MMSE (275.9 ± 193.3€ [mean ± sd euros]) than with Phototest (208.2 ± 196.8€) or MIS (201.3 ± 193.4€), whose costs did not significantly differ. For CI, the effectiveness did not significantly differ between MIS [k = 0.59 (95%CI, 0.45-0.74), DA = 0.79 (95%CI, 0.64-0.97)] and Phototest [k = 0.58 (95%CI, 0.45-0.74), DA = 0.78 (95%CI, 0.64-0.95)] and was lowest for the MMSE [k = 0.27 (95%CI, 0.09-0.45), DA = 0.69 (95%CI, 0.56-0.84)]. Costs were higher for MMSE (393.4 ± 121.8€) than for Phototest (287.0 ± 197.4€) or MIS (300.1 ± 165.6€), whose costs did not significantly differ. CONCLUSION MMSE is not an effective instrument in our setting. For both DEM and CI, the Phototest and MIS are more effective and less costly, with no difference between them. However, MIS could not be applied to the appreciable percentage of our population who were illiterate.
Description: Clinical Trial, Phase III; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't;
URI: http://hdl.handle.net/10668/642
metadata.dc.relation.publisherversion: http://www.biomedcentral.com/1471-2377/11/92
metadata.dc.identifier.doi: 10.1186/1471-2377-11-92
ISSN: 1471-2377 (Online)
Appears in Collections:01- Artículos - Hospital Virgen de las Nieves

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