Bellartz Emily, Pertz Milena, Jungilligens Johannes, Kleffner Ilka, Wellmer Jörg, Schlegel Uwe, Thoma Patrizia, Popkirov Stoyan
Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany.
Neuropsychological Therapy Centre (NTC)/Clinical Neuropsychology, Faculty of Psychology, Ruhr University Bochum, 44801 Bochum, Germany.
Brain Sci. 2022 May 27;12(6):694. doi: 10.3390/brainsci12060694.
Neurocognitive screening instruments usually require printed sheets and additional accessories, and can be unsuitable for low-threshold use during ward rounds or emergency workup, especially in patients with motor impairments. Here, we test the utility of a newly developed neuropsychology pocketcard set for point-of-care testing. For aphasia and neglect assessment, modified versions of the Language Screening Test and the Bells Test were validated on 63 and 60 acute stroke unit patients, respectively, against expert clinical evaluation and the original pen-and-paper Bells Test. The pocketcard aphasia test achieved an excellent area under the curve (AUC) of 0.94 (95% CI: 0.88−1, p < 0.001). Using an optimal cut-off of ≥2 mistakes, sensitivity was 91% and specificity was 81%. The pocketcard Bells Task, measured against the clinical neglect diagnosis, achieved higher sensitivity (89%) and specificity (88%) than the original paper-based instrument (78% and 75%, respectively). Separately, executive function tests (modified versions of the Trail Making Test [TMT] A and B, custom Stroop color naming task, vigilance ‘A’ Montreal Cognitive Assessment item) were validated on 44 inpatients with epilepsy against the EpiTrack® test battery. Pocketcard TMT performance was significantly correlated with the original EpiTrack® versions (A: r = 0.64, p < 0.001; B: r = 0.75, p < 0.001). AUCs for the custom Stroop task, TMT A and TMT B for discriminating between normal and pathological EpiTrack® scores were acceptable, excellent and outstanding, respectively. Quick point-of-care testing using a pocketcard set is feasible and yields diagnostically valid information.
神经认知筛查工具通常需要打印纸张和额外的配件，可能不适用于在查房或急诊检查时进行低门槛使用，尤其是对于有运动障碍的患者。在此，我们测试一种新开发的神经心理学袖珍卡片集用于床旁检测的效用。对于失语症和忽视症评估，分别在63例和60例急性卒中单元患者中对语言筛查测试和钟形测试的改良版本进行了验证，对照专家临床评估和原始纸笔钟形测试。袖珍卡片失语症测试的曲线下面积（AUC）为0.94，表现优异（95%置信区间：0.88 - 1，p < 0.001）。使用≥2个错误的最佳截断值时，敏感性为91%，特异性为81%。与临床忽视诊断相对照，袖珍卡片钟形任务的敏感性（89%）和特异性（88%）高于原始纸质工具（分别为78%和75%）。另外，在44例癫痫住院患者中对照EpiTrack®测试组合对执行功能测试（改良版连线测验[TMT]A和B、定制的斯特鲁普颜色命名任务、警觉性“a”蒙特利尔认知评估项目）进行了验证。袖珍卡片TMT的表现与原始EpiTrack®版本显著相关（A：r = 0.64，p < 0.001；B：r = 0.75，p < 0.001）。用于区分正常和病理性EpiTrack®分数的定制斯特鲁普任务、TMT A和TMT B的AUC分别为可接受、优异和出色。使用袖珍卡片集进行快速床旁检测是可行的，并能产生诊断有效的信息。
