Carnero-Pardo C, Sáez-Zea C, De la Vega Cotarelo R, Gurpegui M
Unidad de Neurología Cognitivo-Conductual, Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, España.
Neurologia. 2012 Mar;27(2):68-75. doi: 10.1016/j.nrl.2011.06.001. Epub 2011 Sep 1.
Fototest is a short simple test, applicable to illiterate subjects and not influenced by educational level. The purpose of this study is to assess its validity for cognitive impairment (CI) and dementia (DEM) under routine clinical practice conditions.
A cross-sectional, multicentre and naturalistic study conducted in General Neurology clinics. The subjects were, over 60 years old, with a previously established diagnosis of no cognitive impairment (NoCI), cognitive impairment without dementia (CInoDEM), or dementia (DEM). The discriminant validity was assessed using the area under the ROC curve (AUC), sensitivity (Sn), specificity (Sp), and probability coefficients. Partial correlations were calculated, adjusted for age, sex and education level with Eurotest, verbal fluency test (VFT) and Global Deterioration Scale (GDS) score to evaluate the concurrent and construct validity.
Nineteen neurologists included a total of 589 subjects: 361 NoCI, 106 CINoDEM and 122 DEM. The discriminant value was better for DEM (AUC 0.94 ± 0.02) than for CI (0.86 ± 0.02). For DEM the best cut-off point was 26/27 (Sn=0.88 [95% CI, 0.93-0.97], Sp=0.87 [95% CI, 0.84-0.90]); and for CI, 28/29 (Sn=0.71 [95% CI, 0.65-0.77], Sp=0.84 [95% CI, 0.80-0.88]). Fototest showed a high and significant correlation with Eurotest (r=0.70 ± 0.02), VFT (r=0.68 ± 0.02) and the GDS score (r=-0.77 ± 0.02).
The Fototest showed adequate validity for CI and DEM in general Neurology clinics in an extensive and wide geographical area.
Fototest是一项简短的简易测试,适用于文盲受试者,且不受教育水平影响。本研究的目的是评估其在常规临床实践条件下对认知障碍(CI)和痴呆(DEM)的有效性。
在普通神经科诊所进行的一项横断面、多中心、自然主义研究。受试者年龄超过60岁,先前已确诊为无认知障碍(NoCI)、无痴呆的认知障碍(CInoDEM)或痴呆(DEM)。使用ROC曲线下面积(AUC)、敏感性(Sn)、特异性(Sp)和概率系数评估判别效度。计算偏相关系数,并根据年龄、性别和教育水平对Eurotest、语言流畅性测试(VFT)和总体衰退量表(GDS)评分进行调整,以评估同时效度和结构效度。
19名神经科医生共纳入589名受试者:361名NoCI、106名CINoDEM和122名DEM。DEM的判别值(AUC 0.94±0.02)优于CI(0.86±0.02)。对于DEM,最佳切点为26/27(Sn=0.88 [95% CI,0.93 - 0.97],Sp=0.87 [95% CI,0.84 - 0.90]);对于CI,最佳切点为28/29(Sn=0.71 [95% CI,0.65 - 0.77],Sp=0.84 [95% CI,0.80 - 0.88])。Fototest与Eurotest(r = 0.70±0.02)、VFT(r = 0.68±0.02)和GDS评分(r = -0.77±0.02)显示出高度显著的相关性。
在广泛的地理区域内,Fototest在普通神经科诊所对CI和DEM显示出足够的有效性。