A new scoring system for increasing the sensitivity of the MMSE
A new scoring system for increasing the sensitivity of the MMSE
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DOI：
10.1007/s00391-019-01516-4
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发表时间：
2020-03-01
影响因子：
1.2
通讯作者：
Kessler, Josef
中科院分区：
文献类型：
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作者：
Hahn, Lisa;Kessler, Josef
背景简易精神状态检查（MMSE）因缺乏敏感性而受到批评，尤其是在轻度痴呆症病例中。有几次尝试通过增加或删除项目来增加灵敏度，但在临床实践中从未被接受。目的为提高简易精神状态检查（MMSE）的敏感性，提出一种新的评分系统，该系统保留原有项目，总分为30分。不改变项目数或总分30分，而是改变了总分30分中不同项目的权重。材料与方法回顾性分析765例精神分裂症患者的神经心理测验资料，确定MMSE各项目的难度。通过纳入项目难度和临床相关性，开发了MMSE的多个评分系统。使用DemTect作为既定指标，将新评分系统的灵敏度与原始评分系统进行比较。结果敏感性提高24.3%，差异有统计学意义。在轻度认知障碍亚组中，新评分系统的灵敏度是原始MMSE的两倍，在痴呆组中，灵敏度增加了8.2%。结论新的MMSE评分系统保留了MMSE的所有项目，总分为30分，具有更高的敏感性，便于临床应用。
Background The mini mental state examination (MMSE) has been criticized for its lack of sensitivity, especially in mild cases of dementia. There have been several attempts to increase the sensitivity by adding or deleting items, which never became accepted in clinical practice. Objective In the current study a new scoring system for improving the sensitivity of the MMSE is proposed, which preserves the original items and the total score of 30 points. Instead of changing the number of items or the total score of 30 points, the weighting of the different items in the total score of 30 points was changed. Material and methods Neuropsychological test data of 765 patients were retrospectively included in the study to determine the difficulty of each MMSE item. Multiple scoring systems for the MMSE were developed by inclusion of the item difficulty and clinical relevance. The sensitivity of the new scoring system was compared to the original scoring system by using the DemTect as an established measure. Results The results showed that an increase of 24.3% in sensitivity was statistically significant. Within the mild cognitive impairment subgroup, the sensitivity of the new scoring system was twice as high in comparison to the original MMSE and within the dementia group the sensitivity was increased by 8.2%. Conclusion A new scoring system with a higher sensitivity than the original MMSE was developed, which can easily be administered in clinical practice because it preserves all items and the total score of 30 points.