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Postoperative cognitive dysfunction: computerized and conventional tests showed only moderate inter-rater

Finn M Radtke1, Martin Franck, Norbert Papkalla

  • 1Department of Anesthesiology and Surgical Critical Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité, Universitätsmedizin, Charitéplatz 1, 10117, Berlin, Germany.

Journal of Anesthesia
|May 29, 2010
PubMed
Summary

The incidence of postoperative cognitive dysfunction (POCD) varied significantly between computerized and paper tests, with paper tests identifying more cases. This highlights the impact of test selection on POCD assessment.

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Area of Science:

  • Neuroscience
  • Medical Psychology

Background:

  • Postoperative cognitive dysfunction (POCD) incidence is influenced by the neuropsychological test battery and calculation methods used.
  • Cognitive assessments can be administered via paper-and-pencil or computerized test batteries.
  • Standardized cognitive domain testing is crucial for accurate POCD evaluation.

Purpose of the Study:

  • To compare the incidence and congruence of POCD detection between computerized and paper-and-pencil test batteries.
  • To evaluate POCD in the same patient cohort using both assessment modalities.

Main Methods:

  • Sixty-seven patients were enrolled, including 30 surgical in-patients and 37 non-surgical controls.
  • Patients completed both paper-and-pencil and computerized test batteries at baseline and 7 days post-assessment.
  • Both test batteries assessed visual attention, visual learning, memory, and processing speed.

Main Results:

  • The computerized battery identified POCD in 10.0% of patients, while the paper-and-pencil battery identified it in 30.0%.
  • A statistically significant difference in POCD incidence was observed between the two test batteries (P = 0.03).
  • Moderate agreement (Cohen's kappa = 0.41) was found between the batteries, with the paper-and-pencil test identifying 6 additional cases.

Conclusions:

  • The incidence of POCD differs based on whether computerized or paper-and-pencil test batteries are employed.
  • Moderate inter-rater reliability exists between computerized and paper-and-pencil test batteries for POCD assessment.
  • Using different test batteries, even those covering similar cognitive domains, can lead to disparate POCD classifications.