Penner Iris-Katharina, Filser Melanie, Bätge Sharon Jean, Renner Alina, Ullrich Sebastian, Lassek Christoph
COGITO Zentrum für Angewandte Neurokognition und Neuropsychologische Forschung, Düsseldorf, Deutschland.
Medizinische Fakultät, Klinik für Neurologie, Heinrich-Heine-Universität, Düsseldorf, Deutschland.
Nervenarzt. 2021 Oct;92(10):1031-1041. doi: 10.1007/s00115-021-01073-5. Epub 2021 Feb 17.
Patients with multiple sclerosis (MS) suffer from cognitive impairment in 40-70% of the cases. There is evidence that the cognitive status is predictive for working ability and early retirement. Regular assessment of cognitive functionality is therefore urgently needed.
The German validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery was evaluated in a multicentric way with respect to its feasibility in private neurological centers across Germany.
Physician assistants were trained with respect to application and scoring of BICAMS. All scored test materials were evaluated by independent neuropsychological experts.
A total of 1606 BICAMS datasets were collected from 65 neurological centers. Of these 1573 datasets were analyzed of which 49.7% were correctly applied and scored while mistakes in application, scoring and transformation were found in 50.3%. Interrater reliability for each subtest was found to be ICC [Formula: see text] 0.953 when datasets containing mistakes were excluded.
In general, BICAMS is highly recommended to be applied in standard clinical care; however, it should be emphasized that although the interrater reliability in the final sample was high, serious mistakes were found in 50.3% of cases. From these findings we conclude that nonpsychological staff have to be even more intensively trained and supervised by experts in the application and scoring of BICAMS.
40%-70%的多发性硬化症（MS）患者存在认知障碍。有证据表明，认知状况可预测工作能力和提前退休情况。因此，迫切需要定期评估认知功能。
以多中心方式评估《多发性硬化症简易国际认知评估量表》（BICAMS）在德国私立神经科中心应用的可行性。
对医师助理进行BICAMS应用和评分方面的培训。所有评分后的测试材料均由独立的神经心理学专家进行评估。
共从65个神经科中心收集了1606份BICAMS数据集。其中分析了1573份数据集，49.7%的数据集应用和评分正确，50.3%的数据集在应用、评分和转换方面存在错误。排除包含错误的数据集后，每个子测试的评分者间信度为组内相关系数[公式：见原文]0.953。
总体而言，强烈建议在标准临床护理中应用BICAMS；然而，应该强调的是，尽管最终样本中的评分者间信度很高，但50.3%的病例中仍发现了严重错误。从这些发现中我们得出结论，非心理学专业人员在BICAMS的应用和评分方面必须接受专家更深入的培训和监督。
