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1分钟动物试验作为糖尿病患者精神状态筛查检查

The 1-min animal test as a mental status screening examination in patients with diabetes.

作者信息

Kinuhata Shigeki, Takemoto Yasuhiko, Senda Mariko, Nakai Shiho, Tsumura Erika, Otoshi Tatsuyuki, Hiratani Sadahiko, Fukumoto Kazuo, Namikawa Hiroki, Tochino Yoshihiro, Morimura Mina, Shuto Taichi, Uchimoto Sadahiko

机构信息

1Department of Medical Education and General Practice, Osaka City University Graduate School and Faculty of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585 Japan.

Fujiidera Municipal Hospital, Fujiidera, Japan.

出版信息

Asia Pac Fam Med. 2018 Jun 7;17:6. doi: 10.1186/s12930-018-0043-0. eCollection 2018.

Abstract

BACKGROUND

Detecting and treating dementia at an early stage are important. Although the Revised Hasegawa Dementia Scale (HDS-R) is commonly used to detect dementia, it takes about 10 min to complete. In contrast, the 1-min animal test (OMAT) takes only 1 min to complete and may be a helpful screening test for general practitioners in deciding whether to proceed with administering further diagnostic tests such as the HDS-R. We sought to examine the relationship between the OMAT and HDS-R scores, and determine the cut-off OMAT score that balanced the sensitivity and specificity in identifying HDS-R-positive patients.

METHODS

A total of 122 consecutive patients with diabetes who visited the outpatient clinic at the Fujiidera Municipal Hospital were enrolled. The patients underwent the OMAT and HDS-R on the same day. Tests were conducted in a single-blinded manner. The relationship between the OMAT and HDS-R scores was examined using Spearman's rank correlation. Receiver operating characteristic curve analysis was performed to identify the optimal cut-off score of OMAT that will determine whether to proceed with further diagnostic tests.

RESULTS

A strong positive correlation between the OMAT and HDS-R scores was observed (r = 0.70). The sensitivity and specificity of OMAT using cut-off scores of 12/13, 13/14, and 14/15 for HDS-R-positive patients were 0.87 and 0.66, 1.00 and 0.51, and 1.00 and 0.40, respectively among all the subjects. Similar results were obtained in a subgroup of subjects aged ≥ 65 years.

CONCLUSIONS

A cut-off score of 13/14 on the OMAT balanced the sensitivity closest to 1.00 and allowed for the highest specificity for the HDS-R not only among all the patients, but also among just the patients aged ≥ 65 years. The OMAT may be an optimal screening test to determine whether to proceed with further diagnosis using HDS-R. UMIN UMIN000025260. This study is retrospectively registered on December 13th, 2016.

摘要

背景

早期发现和治疗痴呆症很重要。虽然修订版长谷川痴呆量表(HDS-R)常用于检测痴呆症,但完成该量表大约需要10分钟。相比之下,1分钟动物试验(OMAT)仅需1分钟即可完成,对于全科医生决定是否进一步进行诸如HDS-R等诊断测试而言,可能是一种有用的筛查测试。我们试图研究OMAT与HDS-R分数之间的关系,并确定在识别HDS-R阳性患者时平衡敏感性和特异性的OMAT分数临界值。

方法

共有122名连续到藤井寺市立医院门诊就诊的糖尿病患者纳入研究。这些患者在同一天接受了OMAT和HDS-R测试。测试采用单盲方式进行。使用Spearman等级相关性检验来研究OMAT与HDS-R分数之间的关系。进行受试者操作特征曲线分析,以确定能够决定是否进一步进行诊断测试的OMAT最佳临界分数。

结果

观察到OMAT与HDS-R分数之间存在强正相关(r = 0.70)。对于HDS-R阳性患者,使用12/13、13/14和14/15的临界分数时,OMAT在所有受试者中的敏感性和特异性分别为0.87和0.66、1.00和0.51、1.00和0.40。在年龄≥65岁的受试者亚组中也获得了类似结果。

结论

OMAT的临界分数为13/14时,不仅在所有患者中,而且在年龄≥65岁的患者中,平衡了最接近1.00的敏感性,并使HDS-R具有最高特异性。OMAT可能是一种用于确定是否使用HDS-R进行进一步诊断的最佳筛查测试。UMIN UMIN000025260。本研究于2016年12月13日进行回顾性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ec9/5992673/38f773d6e3f3/12930_2018_43_Fig1_HTML.jpg

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