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A comparison of five clock scoring methods using ROC (receiver operating characteristic) curve analysis.
J E Storey1, J T Rowland, D Basic
1Geriatrics and Rehabilitation, Liverpool Hospital, Sydney, NSW, Australia. joella.storey@swsahs,nsw.gov.au
International Journal of Geriatric Psychiatry
|May 3, 2001
Summary
The Shulman and Mendez clock scoring methods showed the highest accuracy in detecting dementia, though overall accuracy was modest. Clock drawing alone is not recommended for dementia screening without further evidence.
Area of Science:
- Geriatric Medicine
- Neurology
- Psychometry
Background:
- Dementia screening is crucial for early intervention.
- Clock drawing tests are commonly used cognitive assessments.
- Various scoring methods exist for the clock drawing test.
Purpose of the Study:
- To compare the diagnostic accuracy of five distinct clock scoring methods for dementia detection.
- To evaluate the reliability and predictive accuracy of each method.
Main Methods:
- A prospective cohort study involving 127 geriatric outpatients.
- Clock drawing tests were administered by a blinded observer.
- Patients were assessed by a geriatrician using established diagnostic criteria and cognitive tests.
- Five scoring methods (Mendez, Shulman, Sunderland, Watson, Wolf-Klein) were evaluated using receiver operating characteristic (ROC) curve analysis.
Main Results:
- The Shulman (0.79) and Mendez (0.78) methods demonstrated the highest area under the ROC curve.
- These methods were significantly more accurate than the Sunderland (0.71) and Watson (0.65) methods.
- All five methods exhibited high inter-rater (0.81-0.93) and intra-rater (0.87-0.96) reliability.
Conclusions:
- While differences exist, the accuracy of all tested clock scoring methods for dementia detection was modest.
- Caution is advised against using clock drawing tests as a sole screening tool for dementia.
- Further research in diverse settings is needed to validate these findings.