CLOCK COMPLETION - AN OBJECTIVE SCREENING-TEST FOR DEMENTIA
CLOCK COMPLETION - AN OBJECTIVE SCREENING-TEST FOR DEMENTIA
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DOI：
10.1111/j.1532-5415.1993.tb07308.x
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发表时间：
1993-11-01
影响因子：
6.3
通讯作者：
BIRGE, SJ
中科院分区：
文献类型：
--
作者：
WATSON, YI;ARFKEN, CL;BIRGE, SJ
目的研制一种简易、易操作、易评分的老年性痴呆筛查测验。设计回顾分析抽钟错误和前瞻性验证。设置以医院为基础的门诊老年评估诊所、康复服务、老年公寓楼和长期护理设施。参与者便利样本前往老年评估门诊、康复服务、老年公寓和长期护理设施钟表评分系统识别痴呆患者的灵敏度和特异度的测量，以及该系统与短祝福测验(SBT)在痴呆诊断和测试的前瞻性验证中的比较。结果在评估的10个时钟绘制错误中，在区分不可逆性痴呆患者和不符合NINCDS-ADRDA可能痴呆标准的其他疾病患者方面，数字放置在预先绘制的圆圈中具有最高的敏感性和特异性。与SBT诊断痴呆的敏感性为82%和特异性为88%相比，该评分系统的敏感性和特异性分别为87%和82%。区分痴呆和非痴呆的重测信度为82%，时钟完成度Kappa为0.63，SBT重测信度为82%，Kappa为0.62。评分员间对时钟补全的信度为0.90~0.93。结论建立了一套简单、完全客观的时钟补全评分系统，该评分系统只涉及预先绘制的圆圈第四象限内的数字个数。这种易于实施的测试在筛查痴呆症方面与较长的六项SBT一样有效。
Objective To develop a simple, readily administered and scored screening test for dementia utilizing the clock-drawing task.Design Retrospective analysis of clock-drawing errors and prospective validations.Setting Hospital-based outpatient geriatric assessment clinic, rehabilitation service, apartment building for older adults, and long-term care facility.Participants Convenience sample of patients attending the geriatric assessment clinic, patients on the rehabilitation service, or residents of the above sites.Measurements Sensitivity and specificity of a clock-scoring system in identifying patients with dementia and the comparison of this system with the Short Blessed Test (SBT) in the diagnosis of dementia and in the prospective validation of the test.Results Of the 10 clock-drawing errors evaluated, placement of digits in a pre-drawn circle had the greatest sensitivity and specificity in distinguishing patients with irreversible dementia from patients with other disorders who did not meet NINCDS-ADRDA criteria for probable dementia. The derived scoring system had a sensitivity of 87% and a specificity of 82%, compared with a sensitivity of 82% and a specificity of 88% for the SBT in identifying dementia. Test-retest reliability for the distinction between demented and non-demented was 82%, with a Kappa of 0.63 for the clock completion, and 82%, with a Kappa of 0.62 for the SBT. Inter-rater reliability for clock completion was 0.90 to 0.93.Conclusion A simple, completely objective scoring system for a clock completion test has been developed which involves only the number of digits placed in the fourth quadrant of a pre-drawn circle. This readily administered test is as effective in screening for dementia as the longer six-item SBT.