Test Accuracy of Informant-Based Cognitive Screening Tests for Diagnosis of Dementia and Multidomain Cognitive Impairment in Stroke
Test Accuracy of Informant-Based Cognitive Screening Tests for Diagnosis of Dementia and Multidomain Cognitive Impairment in Stroke
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DOI：
10.1161/strokeaha.115.011218
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发表时间：
2016-02-01
期刊：
影响因子：
8.3
通讯作者：
Quinn, Terence J.
中科院分区：
文献类型：
--
作者：
McGovern, Aine;Pendlebury, Sarah T.;Quinn, Terence J.
背景和目的：卒中后认知评估可以使用为家属或护理人员设计的标准化问卷进行。我们试图描述这种基于信息的评估诊断痴呆/多领域认知功能障碍中风的测试准确性。方法，我们进行了系统的回顾，使用敏感的搜索策略跨多学科的电子数据库。我们创建了总结测试的准确性指标，并描述了报告和质量使用STARDdem和诊断准确性研究（QUADAS）的工具，分别。10篇论文使用了老年人认知衰退知情人问卷（IQCODE）。4项研究描述了IQCODE诊断卒中后痴呆（n=1197）;概括敏感性：0.81（95%置信区间，0.60-0.93）;概括特异性：0.83（95%置信区间，0.64-0.93）。5项研究将IQCODE描述为预测未来痴呆的工具（n=837）;概括敏感性：0.60（95%置信区间，0.32-0.83）;概括特异性：0.97（95%置信区间，0.70-1.00）。所有的论文至少有一个方面的研究报告或quality.Conclusions-There是一个有限的文献在中风的线人认知评估的问题。IQCODE作为诊断工具具有与其他筛查工具相似的测试特性，IQCODE作为预后工具具有特异性但不敏感。我们没有发现描述用于诊断中风前认知下降的线人测试的测试准确性的论文，很少有关于中风后痴呆的论文，并且所有纳入的论文都存在潜在偏倚的问题。
Background and Purpose-Poststroke cognitive assessment can be performed using standardized questionnaires designed for family or care givers. We sought to describe the test accuracy of such informant-based assessments for diagnosis of dementia/multidomain cognitive impairment in stroke.Methods-We performed a systematic review using a sensitive search strategy across multidisciplinary electronic databases. We created summary test accuracy metrics and described reporting and quality using STARDdem and Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tools, respectively.Results-From 1432 titles, we included 11 studies. Ten papers used the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Four studies described IQCODE for diagnosis of poststroke dementia (n=1197); summary sensitivity: 0.81 (95% confidence interval, 0.60-0.93); summary specificty: 0.83 (95% confidence interval, 0.64-0.93). Five studies described IQCODE as tool for predicting future dementia (n=837); summary sensitivity: 0.60 (95% confidence interval, 0.32-0.83); summary specificity: 0.97 (95% confidence interval, 0.70-1.00). All papers had issues with at least 1 aspect of study reporting or quality.Conclusions-There is a limited literature on informant cognitive assessments in stroke. IQCODE as a diagnostic tool has test properties similar to other screening tools, IQCODE as a prognostic tool is specific but insensitive. We found no papers describing test accuracy of informant tests for diagnosis of prestroke cognitive decline, few papers on poststroke dementia and all included papers had issues with potential bias.