VALIDATION OF THE MINIMUM DATA SET COGNITIVE PERFORMANCE SCALE - AGREEMENT WITH THE MINI-MENTAL-STATE-EXAMINATION
VALIDATION OF THE MINIMUM DATA SET COGNITIVE PERFORMANCE SCALE - AGREEMENT WITH THE MINI-MENTAL-STATE-EXAMINATION
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DOI：
10.1093/gerona/50a.2.m128
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发表时间：
1995-03-01
影响因子：
5.1
通讯作者：
PHILLIPS, CD
中科院分区：
文献类型：
--
作者：
HARTMAIER, SL;SLOANE, PD;PHILLIPS, CD
背景。 1987 年《综合预算调节法案》要求美国几乎所有疗养院使用称为最小数据集 (MDS) 的标准工具来评估每位居民的功能、医疗、心理和认知状态。我们报告了一项验证研究，表明 MDS 认知表现量表 (CPS) 是一种由 5 个 MDS 项目（昏迷状态、决策、短期记忆、自我理解和饮食）生成的认知测量方法，可用于检测简易精神状态检查 (MMSE) 定义的认知障碍。从北卡罗来纳州的 8 个疗养院设施中随机招募了 200 名受试者。两名医学生负责 MMSE，一名老年研究护士负责收集 MDS 认知项目，其中包括生成 CPS 分数所需的 5 个项目。认知障碍是根据教育程度调整后的 MMSE 分数来定义的。然后评估 CPS 和 MMSE 在识别认知障碍受试者方面的一致性。结果。 CPS 在识别认知障碍方面与 MMSE 基本一致；敏感性为 0.94（95% 置信区间 [CI]：0.90, .98），特异性为 0.94（95% CI：0.87，.96），通过受试者工作特征 (ROC) 曲线下面积测量的诊断准确性为 0.96（95% CI：0.88，1.0）。 MDS 认知表现量表由经过培训的研究护士使用推荐方案进行，可以有效衡量疗养院居民的认知状态。
Background. Almost all nursing homes in the United States are required by the 1987 Omnibus Budget Reconciliation Act to assess each resident's functional, medical, psychosocial, and cognitive status using a standard instrument known as the Minimum Data Set (MDS). We report a validation study to show that the MDS Cognitive Performance Scale (CPS), a cognitive measure generated from 5 MDS items (comatose status, decision making, short-term memory, making self understood, and eating) can be used to detect cognitive impairment as defined by the Mini-Mental State Examination (MMSE).Methods. Two hundred subjects were randomly recruited from 8 nursing home facilities in North Carolina. Two medical students administered the MMSE, while a geriatric research nurse was responsible for collecting MDS cognitive items, which included the 5 items required for generating CPS scores. Cognitive impairment was defined by MMSE scores adjusted for education. Agreement between the CPS and the MMSE in identifying cognitively impaired subjects was then evaluated.Results. The CPS showed substantial agreement with the MMSE in the identification of cognitive impairment; the sensitivity was .94 (95% confidence interval [CI]: .90, .98), the specificity was .94 (95% CI: .87, .96), and the diagnostic accuracy as measured by the area under the receiver operating characteristics (ROC) curve was .96 (95% CI: .88, 1.0)Conclusions. The MDS Cognitive Performance Scale, when performed by a trained research nurse using recommended protocols, provides a valid measure of cognitive status in nursing home residents.