Memory Clinic, 5 Borough Partnership NHS Trust, Brooker Centre, Halton Hospital, Runcorn, UK.
Int J Geriatr Psychiatry. 2011 Sep;26(9):976-80. doi: 10.1002/gps.2639. Epub 2010 Dec 28.
Test Your Memory (TYM) test is a recently described cognitive test instrument designed to be self-administered under medical supervision. The pragmatic role of such self-administered tests in cognitive clinics has not previously been examined. We investigated the diagnostic utility of the TYM as an independent test to differentiate patients with and without dementia at initial clinical diagnostic interview in dedicated memory clinics.
TYM was administered to consecutive new patient referrals to two memory clinics independent of other tests [Mini-Mental State Examination (MMSE) and the Addenbrooke's Cognitive Examination-Revised] which were used to establish diagnoses according to standard diagnostic criteria (DSM-IV), and results were compared.
In a cohort of 224 patients, 35% fulfilling clinical diagnostic criteria for dementia, TYM proved easy to use and acceptable to patients. Downward adjustment of the TYM test cutoff to ≤30/50, compared to ≤42/50 used in the index study, proved necessary to maximise test accuracy and specificity. Using this revised cutoff, TYM showed comparable diagnostic utility (sensitivity 0.73, specificity 0.88, positive predictive value 0.77, negative predictive value 0.86 and area under receiver operating characteristic curve 0.89) to the MMSE and the Addenbrooke's Cognitive Examination-Revised for the differentiation of cases of dementia from non-dementia.
TYM is a useful screening test in the cognitive function clinic setting, with patients who fall below the designated cutoff requiring further investigation to ascertain a cause for their cognitive impairment. Self-administered tests such as TYM may be of particular value in situations where clinician time is limited.
Test Your Memory（TYM）测试是一种最近描述的认知测试工具，旨在在医疗监督下进行自我管理。这种自我管理的测试在认知诊所中的实际作用以前没有被研究过。我们调查了 TYM 在专门的记忆诊所中作为一种独立的测试，在初始临床诊断访谈中区分有和没有痴呆的患者的诊断效用。
TYM 被连续地用于两个记忆诊所的新患者转诊，独立于其他测试[Mini-Mental State Examination（MMSE）和 Addenbrooke's Cognitive Examination-Revised]，这些测试用于根据标准诊断标准（DSM-IV）建立诊断，然后比较结果。
在 224 名患者的队列中，35%的患者符合痴呆的临床诊断标准，TYM 被证明易于使用和患者可接受。与指数研究中使用的≤42/50 相比，将 TYM 测试截止值向下调整至≤30/50，对于最大限度地提高测试准确性和特异性是必要的。使用这种修订后的截止值，TYM 显示出与 MMSE 和 Addenbrooke's Cognitive Examination-Revised 相当的诊断效用（敏感性 0.73，特异性 0.88，阳性预测值 0.77，阴性预测值 0.86 和接收者操作特征曲线下面积 0.89），用于区分痴呆和非痴呆病例。
TYM 是认知功能诊所设置中的一种有用的筛选测试，低于指定截止值的患者需要进一步调查以确定其认知障碍的原因。自我管理的测试，如 TYM，在临床医生时间有限的情况下可能特别有价值。
