Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California San Diego, San Diego, CA 92103, USA.
J Clin Exp Neuropsychol. 2008 Jan;30(1):83-90. doi: 10.1080/13803390701233865. Epub 2007 Apr 20.
The aim of the current study was to develop and validate demographically adjusted normative standards for the HIV Dementia Scale (HDS). Given the association between demographic variables and the HDS summary score, demographically adjusted normative standards may enhance the classification accuracy of the HDS. Demographically adjusted normative standards were derived from a sample of 182 seronegative healthy participants and were subsequently applied to a sample of 135 HIV-1 seropositive individuals with multidisciplinary case conference diagnoses of HIV-1-associated neurocognitive disorders (e.g., HIV-1-associated dementia and minor-cognitive/motor disorder) in proportions consistent with published epidemiologic reports. In the normative sample, age and education (and their interaction) emerged as the only demographic factors significantly associated with the HDS. In comparison to the traditional HDS cut score (raw score total <or=10), use of the demographically adjusted normative standards significantly improved the sensitivity (from 17.2% to 70.7%, respectively) and overall classification accuracy (increasing the odds ratio from 3 to approximately 6) of the HDS for identifying participants with HIV-1-associated neurocognitive disorders. The application of demographically adjusted normative standards on the HDS improves the clinical applicability and accuracy of this cognitive screening measure in the detection of HIV-1-associated neurocognitive disorders.
本研究旨在制定并验证经过人口统计学调整的 HIV 痴呆量表(HDS)的常模标准。鉴于人口统计学变量与 HDS 总分之间存在关联,因此经过人口统计学调整的常模标准可能会提高 HDS 的分类准确性。经过人口统计学调整的常模标准源于 182 名血清阴性健康参与者的样本,随后将其应用于 135 名 HIV-1 血清阳性个体的样本中,这些个体通过多学科病例会议诊断患有 HIV-1 相关神经认知障碍(如 HIV-1 相关痴呆和轻微认知/运动障碍),其比例与已发表的流行病学报告一致。在常模样本中,年龄和教育(及其相互作用)是唯一与 HDS 显著相关的人口统计学因素。与传统的 HDS 截断分数(原始分数总和<或=10)相比,使用经过人口统计学调整的常模标准显著提高了 HDS 识别 HIV-1 相关神经认知障碍患者的敏感性(分别从 17.2%提高到 70.7%)和总体分类准确性(将优势比从 3 提高到约 6)。在 HDS 中应用经过人口统计学调整的常模标准可提高该认知筛查工具在检测 HIV-1 相关神经认知障碍方面的临床适用性和准确性。