UCLA/Jewish Home Borun Center for Gerontological Research, Los Angeles, CA, USA.
J Am Med Dir Assoc. 2012 Sep;13(7):611-7. doi: 10.1016/j.jamda.2012.06.004. Epub 2012 Jul 15.
To test the feasibility and validity of the Brief Interview for Mental Status (BIMS) as a performance-based cognitive screener that could be easily completed by nursing home staff. The current study examines the performance of the BIMS as part of the national testing of the Minimum Data Set 3.0 (MDS 3.0) for Nursing Homes.
The BIMS was tested as part of the national MDS 3.0 evaluation study among 3822 residents scheduled for MDS 2.0 assessments. Residents were from 71 community nursing homes (NHs) in eight states. Residents were randomly included in a feasibility sample (n = 3258) and a validation sample (n = 418). Cognition was assessed with three instruments: the Brief Interview for Mental Status (BIMS), the MDS 2.0 Cognitive Performance Scale (CPS), and the Modified Mini-Mental State Examination (3MS). Trained research nurses administered the 3MS and BIMS to all subjects in the validation study. The CPS score was determined based on the MDS 2.0 completed by nursing home staff who had undergone additional training on cognitive testing. Standard cutoff scores on the 100-point 3MS were used as the gold standard for any cognitive impairment (<78) and for severe impairment (<48). Staff impressions were obtained from anonymous surveys.
The BIMS was attempted and completed in 90% of the 3258 residents in the feasiblity sample. BIMS scores covered the full instrument range (0-15). In the validation sample, correlation with the criterion measure (3MS) was higher for BIMS (0.906, P < .0001) than for CPS (-0.739, P < .0001); P < .01 for difference. For identifying any impairment, a BIMS score of 12 had sensitivity = 0.83 and specificity = 0.91; for severe impairment, a BIMS score of 7 had sensitivity = 0.83 and specificity = 0.92. The area under the receiver operator characteristics curve, a measure of test accuracy, was higher for BIMS than for CPS for identifying any impairment (AUC = 0.930 and 0.824, respectively) and for identifying severe impairment (AUC = 0.960 and 0.857, respectively). Eighty-eight percent of survey respondents reported that the BIMS provided new insight into residents' cognitive abilities. The average time for completing the BIMS was 3.2 minutes.
The BIMS, a short performance-based cognitive screener expressly designed to facilitate cognitive screening in MDS assessments, was completed in the majority of NH residents scheduled for MDS assessments in a large sample of NHs, demonstrating its feasibility. Compared with MDS 2.0 observational items, the BIMS performance-based assessment approach was more highly correlated with a criterion cognitive screening test and demonstrated greater accuracy. The majority of surveyed staff reported improved assessments with the new approach.
测试简短心理状态访谈（BIMS）作为一种易于由养老院工作人员完成的基于表现的认知筛查工具的可行性和有效性。本研究作为全国测试养老院最低数据集 3.0（MDS 3.0）的一部分，检验了 BIMS 的性能。
BIMS 作为全国 MDS 3.0 评估研究的一部分，对计划接受 MDS 2.0 评估的 3822 名居民进行了测试。居民来自八个州的 71 个社区养老院（NHs）。居民随机纳入可行性样本（n=3258）和验证样本（n=418）。使用三种工具评估认知：简短心理状态访谈（BIMS）、MDS 2.0 认知表现量表（CPS）和改良的简易精神状态检查（3MS）。经过培训的研究护士对验证研究中的所有受试者进行了 3MS 和 BIMS 的测试。CPS 评分是根据接受过认知测试额外培训的养老院工作人员完成的 MDS 2.0 确定的。使用 3MS 的标准 100 分截断值作为任何认知障碍（<78）和严重障碍（<48）的金标准。从匿名调查中获得工作人员的印象。
在可行性样本中的 3258 名居民中，有 90%尝试并完成了 BIMS。BIMS 分数涵盖了整个仪器范围（0-15）。在验证样本中，与标准测量（3MS）的相关性更高对于 BIMS（0.906，P<.0001）而不是 CPS（-0.739，P<.0001）；差异具有统计学意义（P<.01）。对于识别任何障碍，BIMS 得分为 12 时的灵敏度=0.83，特异性=0.91；对于严重障碍，BIMS 得分为 7 时的灵敏度=0.83，特异性=0.92。测试准确性的衡量标准接收器操作特性曲线下面积，对于识别任何障碍（AUC=0.930 和 0.824，分别）和识别严重障碍（AUC=0.960 和 0.857，分别），BIMS 的 AUC 均高于 CPS。88%的调查受访者报告说，BIMS 提供了对居民认知能力的新见解。完成 BIMS 的平均时间为 3.2 分钟。
BIMS 是一种简短的基于表现的认知筛查工具，专门设计用于促进 MDS 评估中的认知筛查，在 MDS 评估中计划对大量 NH 居民进行的 NH 中大型样本中，大多数居民都完成了 BIMS，证明了其可行性。与 MDS 2.0 观察项目相比，BIMS 基于表现的评估方法与标准认知筛查测试的相关性更高，并且具有更高的准确性。大多数接受调查的工作人员报告说，采用新方法进行评估有所改善。
