Test Accuracy of Cognitive Screening Tests for Diagnosis of Dementia and Multidomain Cognitive Impairment in Stroke
Test Accuracy of Cognitive Screening Tests for Diagnosis of Dementia and Multidomain Cognitive Impairment in Stroke
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DOI：
10.1161/strokeaha.114.005842
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发表时间：
2014-10-01
期刊：
影响因子：
8.3
通讯作者：
Quinn, Terence J.
中科院分区：
文献类型：
--
作者：
Lees, Rosalind;Selvarajah, Johann;Quinn, Terence J.
背景和目的：指南推荐对中风幸存者进行认知障碍筛查。我们试图整理已发表的关于认知筛选工具测试准确性的数据。方法-指数测试是任何直接的认知筛查评估，与（未分化）多领域认知障碍/痴呆的参考标准诊断进行比较。我们使用一个敏感的搜索语句来搜索多个跨学科的数据库，从成立到2014年1月。题目、摘要和文章均由独立研究人员筛选。我们使用诊断准确性研究质量评估工具描述偏倚风险，使用诊断准确性报告标准指南描述偏倚风险。在数据允许的情况下，我们使用双变量方法汇总测试精度。结果：我们从19182篇文献中筛选出241篇，其中35篇适合纳入。有实质性的异质性：25种不同的筛选试验；不同的中风设置（急性中风，n=11篇文章）和使用的参考标准（神经心理学系列，n=21篇文章）。一篇文章被评为低偏倚风险；常见的问题是病例对照方法学（n=7篇）和缺失数据（n=22篇）。我们汇集了4项不同筛查阳性阈值的测试数据：阿登布鲁克认知检查-修订(
Background and Purpose-Guidelines recommend screening stroke-survivors for cognitive impairments. We sought to collate published data on test accuracy of cognitive screening tools.Methods-Index test was any direct, cognitive screening assessment compared against reference standard diagnosis of (undifferentiated) multidomain cognitive impairment/dementia. We used a sensitive search statement to search multiple, cross-disciplinary databases from inception to January 2014. Titles, abstracts, and articles were screened by independent researchers. We described risk of bias using Quality Assessment of Diagnostic Accuracy Studies tool and reporting quality using Standards for Reporting of Diagnostic Accuracy guidance. Where data allowed, we pooled test accuracy using bivariate methods.Results-From 19 182 titles, we reviewed 241 articles, 35 suitable for inclusion. There was substantial heterogeneity: 25 differing screening tests; differing stroke settings (acute stroke, n=11 articles), and reference standards used (neuropsychological battery, n=21 articles). One article was graded low risk of bias; common issues were case-control methodology (n=7 articles) and missing data (n=22). We pooled data for 4 tests at various screen positive thresholds: Addenbrooke's Cognitive Examination-Revised (