Predictive validity of global deficit scores in detecting neuropsychological impairment in HIV infection
Predictive validity of global deficit scores in detecting neuropsychological impairment in HIV infection
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DOI：
10.1080/13803390490510031
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发表时间：
2004-05-01
影响因子：
2.2
通讯作者：
Heaton, RK
中科院分区：
文献类型：
--
作者：
Carey, CL;Woods, SP;Heaton, RK
目前的研究探讨了全球缺陷评分（GDS）方法在总结神经心理学（NP）测试结果方面的预测有效性，特别是在检测hiv相关认知障碍方面。对88名HIV阳性受试者和61名年龄、教育程度和种族相当的健康HIV对照者进行了全面的NP测试。经过人口统计学校正的测试数据被转换为GDS， GDS通过量化整个测试过程中受损性能的数量和程度来模拟临床医生的评分，而对优异性能和/或正常范围内的性能的重要性相对较低。研究结果表明，GDS方法能够有效区分HIV+和正常对照组，并根据“金标准”临床评分方法对HIV+患者进行准确的NP障碍分类。与以往使用不同受试者样本和不同NP测试电池的研究一致，大于等于0.50的GDS切点在NP损伤分类的敏感性和特异性之间达到了最佳平衡，从而支持了该方法的可推广性。此外，GDS在多个切点上预测NP损伤的能力相当强，阳性预测能力值在0.71到1.00之间。这些发现支持GDS作为总结NP测试结果的临床有用方法的有效性。
The current study explored the predictive validity of the Global Deficit Score (GDS) approach in summarizing neuropsychological (NP) test results, and specifically in detecting HIV-associated cognitive impairment. A comprehensive NP test battery was administered to 88 HIV+ subjects and 61 healthy HIV-controls comparable for age, education, and ethnicity. Demographically corrected test data were converted to a GDS, which simulates clinicians' ratings by quantifying the number and degree of impaired performances throughout the test battery while attaching relatively less significance to superior performances and/or those within normal limits. Our results indicated that the GDS approach effectively discriminated HIV+ and normal control groups, and accurately classified HIV+ individuals with NP impairment based on the "gold standard" clinical rating approach. Consistent with previous studies using different subject samples and different NP test batteries, the GDS cutpoint of greater than or equal to0.50 yielded optimal balance between sensitivity and specificity in classifying NP impairment, thus supporting the generalizability of the method. Moreover, the ability of the GDS to predict NP impairment across several cutpoints was quite strong, with positive predictive power values ranging from 0.71 to 1.00. These findings support the validity of the GDS as a clinically useful way of summarizing results on NP testing.