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Diagnostic accuracy of a new instrument for detecting cognitive dysfunction
1Mental Health Service (11 M), Veterans Affairs New York Harbor Healthcare System, New York Campus, New York, NY, USA. Steven.Cercy@va.gov
Background:
Effective screening of cognitive disorders is limited by psychometric and practical properties of available instruments. The Brief Cognitive Screen (BCS) was developed to improve sensitivity and overall diagnostic accuracy of case detection for cognitive dysfunction in a quick and convenient format.
Methods:
This validation study compared psychometric properties of the BCS with the Mini mental state examination (MMSE) in 308 patients with suspected or known disorders of cognition. Diagnostic accuracy of the MMSE was determined using the traditional 23/24 clinical cutoff and area under the curve (AUC) from receiver operating characteristics (ROC) analyses. Diagnostic accuracy of BCS summary scores and components was determined by ROC analyses. Comprehensive neuropsychological evaluation served as the criterion standard for determining cognitive dysfunction.
Results:
The MMSE sensitivity (34.8%) was inadequate at the 23/24 cutoff. Under ROC analyses, diagnostic accuracy of a BCS summary score was superior (AUC = 0.950) to the MMSE total score (AUC = 0.862) for the total sample. Excluding all patients with a history of cognitive deficit, classification accuracy of the BCS remained high (AUC = 0.936).
Conclusions:
Findings suggest that BCS is an effective, convenient alternative screening instrument for use in clinical populations with suspected cognitive dysfunction.
