Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, China.
Neuropsychol Rev. 2022 Sep;32(3):566-576. doi: 10.1007/s11065-021-09523-2. Epub 2021 Oct 16.
Digital drawing tests have been proposed for cognitive screening over the past decade. However, the diagnostic performance is still to clarify. The objective of this study was to evaluate the diagnostic performance among different types of digital and paper-and-pencil drawing tests in the screening of mild cognitive impairment (MCI) and dementia. Diagnostic studies evaluating digital or paper-and-pencil drawing tests for the screening of MCI or dementia were identified from OVID databases, included Embase, MEDLINE, CINAHL, and PsycINFO. Studies evaluated any type of drawing tests for the screening of MCI or dementia and compared with healthy controls. This study was performed according to PRISMA and the guidelines proposed by the Cochrane Diagnostic Test Accuracy Working Group. A bivariate random-effects model was used to compare the diagnostic performance of these drawing tests and presented with a summary receiver-operating characteristic curve. The primary outcome was the diagnostic performance of clock drawing test (CDT). Other types of drawing tests were the secondary outcomes. A total of 90 studies with 22,567 participants were included. In the screening of MCI, the pooled sensitivity and specificity of the digital CDT was 0.86 (95% CI = 0.75 to 0.92) and 0.92 (95% CI = 0.69 to 0.98), respectively. For the paper-and-pencil CDT, the pooled sensitivity and specificity of brief scoring method was 0.63 (95% CI = 0.49 to 0.75) and 0.77 (95% CI = 0.68 to 0.84), and detailed scoring method was 0.63 (95% CI = 0.56 to 0.71) and 0.72 (95% CI = 0.65 to 0.78). In the screening of dementia, the pooled sensitivity and specificity of the digital CDT was 0.83 (95% CI = 0.72 to 0.90) and 0.87 (95% CI = 0.79 to 0.92). The performances of the digital and paper-and-pencil pentagon drawing tests were comparable in the screening of dementia. The digital CDT demonstrated better diagnostic performance than paper-and-pencil CDT for MCI. Other types of digital drawing tests showed comparable performance with paper-and-pencil formats. Therefore, digital drawing tests can be used as an alternative tool for the screening of MCI and dementia.
在过去的十年中，已经提出了数字绘图测试来进行认知筛查。然而，其诊断性能仍需阐明。本研究的目的是评估不同类型的数字和纸笔绘图测试在轻度认知障碍（MCI）和痴呆症筛查中的诊断性能。从 OVID 数据库（包括 Embase、MEDLINE、CINAHL 和 PsycINFO）中确定了评估数字或纸笔绘图测试用于 MCI 或痴呆症筛查的诊断研究。研究评估了任何类型的用于 MCI 或痴呆症筛查的绘图测试，并与健康对照组进行了比较。本研究按照 PRISMA 和 Cochrane 诊断测试准确性工作组提出的指南进行。使用双变量随机效应模型比较了这些绘图测试的诊断性能，并呈现了综合受试者工作特征曲线。主要结局是画钟测验（CDT）的诊断性能。其他类型的绘图测试为次要结局。共纳入 90 项研究，共计 22567 名参与者。在 MCI 的筛查中，数字 CDT 的汇总敏感性和特异性分别为 0.86（95%CI=0.75 至 0.92）和 0.92（95%CI=0.69 至 0.98）。对于纸笔 CDT，简短评分方法的汇总敏感性和特异性为 0.63（95%CI=0.49 至 0.75）和 0.77（95%CI=0.68 至 0.84），详细评分方法为 0.63（95%CI=0.56 至 0.71）和 0.72（95%CI=0.65 至 0.78）。在痴呆症的筛查中，数字 CDT 的汇总敏感性和特异性分别为 0.83（95%CI=0.72 至 0.90）和 0.87（95%CI=0.79 至 0.92）。在痴呆症的筛查中，数字和纸笔五边形绘图测试的性能相当。数字 CDT 对 MCI 的诊断性能优于纸笔 CDT。其他类型的数字绘图测试与纸笔格式的表现相当。因此，数字绘图测试可以作为 MCI 和痴呆症筛查的替代工具。
