Concurrent Validity of a Computer-Based Cognitive Screening Tool for Use in Adults with HIV Disease
Concurrent Validity of a Computer-Based Cognitive Screening Tool for Use in Adults with HIV Disease
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DOI：
10.1089/apc.2011.0051
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发表时间：
2011-06-01
影响因子：
4.9
通讯作者：
Saxton, Judith
中科院分区：
文献类型：
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作者：
Becker, James T.;Dew, Mary Amanda;Saxton, Judith
随着艾滋病毒相关痴呆症发病率的下降，患有轻度认知障碍的艾滋病毒感染者的存活率有所提高。在早期阶段发现这种较轻微的损害具有重要的临床和研究意义。我们在此报告轻度认知损害计算机评估(CAMCI(R))的初步评估结果，CAMCI(R)是一种计算机化的筛查工具，旨在评估异常认知下降，减轻应答者和测试管理员的负担。59名志愿者(29名感染艾滋病毒；年龄=50.9岁；受教育=14.9岁；36/59名男性)完成了CAMCI(注册商标)和一系列神经心理测试。12周和24周后复查CAMCI。CAMCI的结果与从完整的神经心理测试组合得出的全局和领域损害评分进行了比较。CAMCI检测到轻度损害(与正常和临界性试验相比)，灵敏度为0.72，特异度为0.97，阳性预测率为0.93，阴性预测率为0.89。随访12周和24周的中位稳定度分别为0.32和0.46。这些比率没有作为血清状态的函数而不同。判别函数分析从CAMCI的六个分数中正确地对90%的受试者进行了总体全球损伤评级。这项初步研究表明，CAMCI对轻度认知障碍很敏感，并在24周的随访中保持稳定。为了使该仪器在临床实践和研究(例如，临床试验)中都有用，有必要进行更大规模的试验，以获得风险组适当的规范数据。
As the incidence of HIV-associated dementia has decreased, the survival of HIV-infected individuals with milder forms of cognitive impairment has increased. Detecting this milder impairment in its earliest stages has great clinical and research importance. We report here the results of an initial evaluation of the Computer Assessment of Mild Cognitive Impairment (CAMCI (R)), a computerized screening tool designed to assess abnormal cognitive decline with reduced respondent and test administrator burden. Fifty-nine volunteers (29 HIV infected; age = 50.9 years; education = 14.9 years; 36/59 males) completed the CAMCI (R) and a battery of neuropsychological tests. The CAMCI was repeated 12 and 24 weeks later. The results from the CAMCI were compared to Global and Domain Impairment scores derived from the full neuropsychological test battery. The CAMCI detected mild impairment (compared with normal and borderline test performance) with a sensitivity of 0.72, specificity of 0.97, positive predictive rate of 0.93, and a negative predictive rate of 0.89. Median stability over 12 and 24 weeks of follow-up was 0.32 and 0.46, respectively. These rates did not differ as a function of serostatus. A discriminant function analysis correctly classified 90% of the subjects with respect to their overall Global Impairment Rating from six of the CAMCI scores. This preliminary study demonstrates that the CAMCI is sensitive to mild forms of cognitive impairment, and is stable over 24 weeks of follow-up. A larger trial to obtain risk-group appropriate normative data will be necessary to make the instrument useful in both clinical practice and research (e. g., clinical trials).