JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Aging Ment Health. 2022 May;26(5):1019-1026. doi: 10.1080/13607863.2021.1922599. Epub 2021 May 17.
Drawing is a major component of cognitive screening for dementia. It can be performed without language restriction. Drawing pictures under instructions and copying images are different screening approaches. The objective of this study was to compare the diagnostic performance between drawing under instructions and image copying for MCI and dementia screening.
A literature search was carried out in the OVID databases with keywords related to drawing for cognitive screening. Study quality and risk of bias were assessed by QUADAS-2. The level of diagnostic accuracy across different drawing tests was pooled by bivariate analysis in a random effects model. The area under the hierarchical summary receiver-operating characteristic curve (AUC) was constructed to summarize the diagnostic performance.
Ninety-two studies with sample size of 22,085 were included. The pooled results for drawing under instructions showed a sensitivity of 79% (95% CI: 76 - 83%) and a specificity of 80% (95% CI: 77 - 83%) with AUC of 0.87 (95% CI: 0.83 - 0.89). The pooled results for image copying showed a sensitivity of 71% (95% CI: 62 - 79%) and a specificity of 83% (95% CI: 72 - 90%) with AUC of 0.83 (95% CI: 0.80 - 0.86). Clock-drawing test was the screening test used in the majority of studies.
Drawing under instructions showed a similar diagnostic performance when compared with image copying for cognitive screening and the administration of image copying is relatively simpler. Self-screening for dementia is feasible to be done at home in the near future.
绘画是痴呆认知筛查的主要组成部分。它可以在没有语言限制的情况下进行。根据指令绘画和复制图像是不同的筛查方法。本研究的目的是比较指令下绘画和图像复制在 MCI 和痴呆筛查中的诊断性能。
通过 OVID 数据库中的关键词进行了与认知筛查相关的绘画文献检索。采用 QUADAS-2 评估研究质量和偏倚风险。使用二元分析在随机效应模型中汇总不同绘画测试的诊断准确性。构建层次综合受试者工作特征曲线（AUC）下面积以总结诊断性能。
纳入了 92 项研究，样本量为 22085 人。指令下绘画的汇总结果显示，敏感度为 79%（95%CI：76-83%），特异度为 80%（95%CI：77-83%），AUC 为 0.87（95%CI：0.83-0.89）。图像复制的汇总结果显示，敏感度为 71%（95%CI：62-79%），特异度为 83%（95%CI：72-90%），AUC 为 0.83（95%CI：0.80-0.86）。画钟测验是大多数研究中使用的筛查测试。
与图像复制相比，指令下绘画在认知筛查中具有相似的诊断性能，且图像复制的实施相对更简单。在不久的将来，在家中进行自我痴呆筛查是可行的。
