Zhao Ting-ting, Feng Qi-ming, Liang Hao, Tang Xian-yan, Wei Bo
Public Health College, Guangxi Medical University, Nanning, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2011 Nov;32(11):1101-4.
Using Intelligence Scale of Mini Mental State Estimated (MMSE) as the gold standard to determine the relevance of International HIV-associated Dementia Scale (IHDS) in minority ethnic areas in Guangxi populations with different cultural values. Corresponding boundary value related to the authenticity and reliability on IHDS were also evaluated.
200 patients with HIV infection were randomly selected from the minority ethnic groups in Guangxi. For each infected person, MMSE and IHDS blind scale were tested at the same period. Using the results from MMSE scale test as the gold standard, ROC curve and IHDS scale in Guangxi minority populations with different education levels which related to the diagnosis of dementia-HIV values were determined. The value of a specific sector under the IHDS sensitivity, specificity, and internal consistency coefficients was also evaluated.
When considering the infected person did not differ on their educational level, the IHDS scale diagnostic cutoff appeared as 8.25, while IHDS sensitivity as 0.925, specificity as 0.731 and Kappa as 0.477 (P < 0.001). When considering the extent of cultural differences did influence the prevalence of infection, the different education groups showed different IHDS diagnostic cutoff values. People with high school, secondary school or higher education levels, the IHDS diagnosis appeared to be 8.25, when sensitivity was 0.917, specificity was 0.895 and Kappa was 0.722 (P < 0.001). People with only primary education level, the IHDS appeared to be 7.25. When sensitivity was 0.875, specificity was 0.661 and Kappa was 0.372 (P < 0.001).
The IHDS diagnostic sector in Guangxi minority groups was lower than the internationally recommended level of diagnostic cutoff value (IHDS ≤ 10 points). When using IHDS to perform the HIV related dementia screening program, in the minority areas of Guangxi, culture context, the degree and difference of HIV infection should be considered, especially in using IHDS diagnostic cutoff values.
以简易精神状态检查表（MMSE）智力量表作为金标准，确定国际HIV相关痴呆量表（IHDS）在广西具有不同文化价值观的少数民族地区人群中的相关性。还评估了与IHDS真实性和可靠性相关的相应临界值。
从广西少数民族中随机选取200例HIV感染者。对每名感染者同期进行MMSE和IHDS盲法量表测试。以MMSE量表测试结果作为金标准，确定广西不同教育水平少数民族人群中与HIV相关痴呆诊断值相关的ROC曲线和IHDS量表。还评估了IHDS敏感性、特异性和内部一致性系数下特定区间的值。
当不考虑感染者教育水平差异时，IHDS量表诊断临界值为8.25，IHDS敏感性为0.925，特异性为0.731，Kappa值为0.477（P<0.001）。当考虑文化差异程度确实影响感染患病率时，不同教育组显示出不同的IHDS诊断临界值。高中、中专及以上文化程度人群，IHDS诊断临界值为8.25，敏感性为0.917，特异性为0.895，Kappa值为0.722（P<0.001）。仅小学文化程度人群，IHDS诊断临界值为7.25。敏感性为0.875，特异性为0.661，Kappa值为0.372（P<0.001）。
广西少数民族群体中IHDS诊断区间低于国际推荐的诊断临界值水平（IHDS≤10分）。在广西少数民族地区使用IHDS进行HIV相关痴呆筛查项目时，应考虑文化背景、HIV感染程度及差异，尤其是在使用IHDS诊断临界值时。
