Solomon P R, Hirschoff A, Kelly B, Relin M, Brush M, DeVeaux R D, Pendlebury W W
Department of Psychology, Williams College, Williamstown, Mass 01267, USA.
Arch Neurol. 1998 Mar;55(3):349-55. doi: 10.1001/archneur.55.3.349.
To determine the validity and reliability of a rapidly administered neurocognitive screening battery consisting of 4 brief tests (Enhanced Cued Recall, Temporal Orientation, Verbal Fluency, and Clock Drawing) to distinguish between patients with probable Alzheimer's disease (AD) and healthy control subjects.
Sixty successive referrals to the Memory Disorders Clinic at Southwestern Vermont Medical Center, Bennington, who were diagnosed as having probable AD and 60 community-dwelling volunteers of comparable age, sex distribution, and education.
Interrater and test-retest reliability, intergroup comparisons between patients with AD and control subjects on the 4 individual tests, and determination of probability of dementia for patients with AD and control subjects using the entire battery of tests.
Outpatient care.
Comparison of the probability of dementia on the 7 Minute Screen with the criterion standard of clinical diagnosis established by examination and laboratory studies.
Test-retest and interrater reliability (correlation coefficients), time for administration.
Mean time of administration was 7 minutes 42 seconds. Mean scores for patients with AD and control subjects on all 4 individual tests were significantly different (for each, P<.001). When the 4 tests were combined in a logistic regression, the battery had a sensitivity of 100% and a specificity of 100%. A series of 1000 repeated random samples of 30 patients with AD and 30 control subjects taken from the overall sample of 60 patients with AD and 60 control subjects had a mean sensitivity of 92% and a mean specificity of 96%. The battery was equally sensitive to patients with mild AD as demonstrated by correctly classifying all 13 patients with AD using Mini-Mental State Examination scores of 24 or higher. Neither age nor education was a statistically significant factor when added as a covariate. Test-retest reliabilities for individual tests ranged from 0.83 to 0.93. Test-retest reliability for the entire battery was 0.91. Interrater reliability for the entire battery was 0.92.
The 7 Minute Screen appears highly sensitive to AD and may be useful in helping to make initial distinctions between patients experiencing cognitive changes related to the normal aging process and those experiencing cognitive deficits related to dementing disorders such as AD. It has reasonable interrater and test-retest reliability, can be administered in a brief period, and requires no clinical judgment and minimal training.
确定一种由4项简短测试（增强线索回忆、时间定向、语言流畅性和画钟测试）组成的快速神经认知筛查组合的有效性和可靠性，以区分可能患有阿尔茨海默病（AD）的患者和健康对照者。
连续60例被转诊至佛蒙特州西南部医疗中心本宁顿分院记忆障碍诊所并被诊断为可能患有AD的患者，以及60名年龄、性别分布和教育程度相当的社区居住志愿者。
评分者间和重测信度、AD患者与对照者在4项单项测试中的组间比较，以及使用整个测试组合确定AD患者和对照者患痴呆症的概率。
门诊护理。
将7分钟筛查中痴呆症的概率与通过检查和实验室研究确立的临床诊断标准进行比较。
重测和评分者间信度（相关系数）、施测时间。
平均施测时间为7分42秒。AD患者和对照者在所有4项单项测试中的平均得分存在显著差异（每项P<0.001）。当将这4项测试纳入逻辑回归时，该测试组合的敏感性为100%，特异性为100%。从60例AD患者和60例对照者的总体样本中抽取的一系列1000个包含30例AD患者和30例对照者的重复随机样本，平均敏感性为92%，平均特异性为96%。该测试组合对轻度AD患者同样敏感，通过使用简易精神状态检查表得分24分及以上，正确分类了所有13例AD患者。将年龄和教育程度作为协变量添加时，两者均不是具有统计学意义的因素。单项测试的重测信度范围为0.83至0.93。整个测试组合的重测信度为0.91。整个测试组合的评分者间信度为0.92。
7分钟筛查对AD似乎高度敏感，可能有助于初步区分与正常衰老过程相关的认知变化患者和与AD等痴呆症相关的认知缺陷患者。它具有合理的评分者间和重测信度，可在短时间内施测，无需临床判断且培训要求最低。
