Benchmarks for designing two-stage studies using modified mini-mental state examinations: experience from the Women's Health Initiative Memory Study
Benchmarks for designing two-stage studies using modified mini-mental state examinations: experience from the Women's Health Initiative Memory Study
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DOI：
10.1191/1740774506cn140oa
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发表时间：
2006-01-01
期刊：
影响因子：
2.7
通讯作者：
Bassford, Tamsen
中科院分区：
文献类型：
--
作者：
Espeland, Mark A.;Rapp, Stephen R.;Bassford, Tamsen
背景 检查痴呆症发病率的研究最有效的方法是使用一个简短的筛查工具来识别参与者，以进行更广泛的测试来识别认知障碍。改良的简易精神状态检查 (3MS) 通常用作此类两阶段设计中的初始筛选，但其这一作用的特性需要进一步研究。目的我们使用女性健康倡议记忆研究的数据来对比两阶段设计中的设计选项。方法该试验招募了 7251 名受过九年或以上教育的参与者，他们年龄在 65-79 岁之间，平均随访时间为四到五年。使用逻辑回归来检查不同两阶段 3MS 切点下的案例产量。对使用不同检查计划和限制高风险女性入学的效率进行了检查。结果 可能的痴呆症与 3MS 分数的显着下降相关。被归类为可能患有痴呆症的女性比例范围为 7.95% (3MS 85-88) 到 50.0% (3MS < 70)。基线 3MS 评分为 100、95、90 和 85 时，检测 1 例可能痴呆症（四年随访）所需的登记女性人数 [95% 置信区间]估计分别为 1477 人 [389, 5618]、253 人 [134, 481]、53 人 [34, 85] 和 14 人 [9, 23]。与年度测试相比，每两年进行一次测试使所需的参加人数增加了 11%，但测试次数减少了 46%。 局限性 我们的研究结果受到研究组的特征、保留率和研究方案的影响，并且可能无法完全推广到其他环境。 结论 3MS 可以作为两阶段研究设计的有效基础和
Background The most efficient approach for studies examining the incidence of dementia involves a brief screening instrument to identify participants for more extensive testing to identify cognitive impairment. The modified mini-mental state examination (3MS) is commonly used as this initial screen in such two-stage designs, however its properties for this role require further study.Purpose We use data from the Women's Health Initiative Memory Study to contrast design options in two-stage designs.Methods This trial enrolled 7251 participants with nine or more years of education who were aged 65-79 and followed an average of four to five years. Logistic regression was used to examine the case yields at varying two-stage 3MS cutpoints. The efficiency of using different examination schedules and restricting enrollment to higher risk women was examined.Results Probable dementia is associated with marked decline in 3MS scores. The percentages of women classified with probable dementia ranged from 7.95% (3MS 85-88) to 50.0% (3MS < 70). The numbers [95% confidence interval] of enrolled women necessary to detect one case of probable dementia (four-year follow-up) for baseline 3MS scores of 100, 95, 90 and 85 were A estimated as 1477 [389, 5618], 253 [134, 481], 53 [34, 85], and 14 [9, 23], respectively. Compared to annual testing, administration every two years increased the number of required enrollees by 11%, but decreased the number of test administrations by 46%.Limitations Our findings are influenced by the characteristics of our study group, its rates of retention, and the study protocol, and may not-fully generalize to other settings.Conclusions The 3MS can serve as an efficient basis for two-stage study designs and a cutpoint of