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The AVERT MoCA Data: Scoring Reliability in a Large Multicenter Trial.

Toby B Cumming1, Danielle Lowe1, Thomas Linden2

  • 1Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.

Assessment
|June 8, 2018
PubMed
Summary
This summary is machine-generated.

The Montreal Cognitive Assessment (MoCA) has variable scoring reliability in stroke patients. Researchers should ensure clear scoring rules and independent checks for accurate cognitive assessment.

Keywords:
cognition disordersdata accuracymulticenter studiesreproducibility of resultsstrokevascular dementia

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Area of Science:

  • Neurology
  • Cognitive Science
  • Clinical Trials

Background:

  • The Montreal Cognitive Assessment (MoCA) is a key tool for cognitive screening in stroke survivors.
  • Subjective judgment in scoring visuospatial/executive MoCA items necessitates reliability assessment.

Purpose of the Study:

  • To evaluate the interrater reliability of MoCA scoring for visuospatial/executive items.
  • To compare original assessor scores with independent rater scores in a large stroke cohort.

Main Methods:

  • Analysis of MoCA scoresheets from 1,119 participants in the A Very Early Rehabilitation Trial (AVERT).
  • Comparison of original assessor scores (n=102) against a single, independent rater's blind scoring.
  • Calculation of agreement percentages and Kappa (κ) statistics for individual MoCA items.

Main Results:

  • Variable interrater reliability was observed across MoCA items.
  • Agreement percentages ranged from 72% (clock hands) to 97% (trail-making).
  • Kappa values indicated substantial agreement for trail-making and cube copy, but moderate to fair for clock items.

Conclusions:

  • The study highlights inconsistencies in MoCA scoring, particularly for clock items.
  • Recommendations include emphasizing scoring rules and implementing independent data checks to improve accuracy in clinical trials.
  • Independent rater was stricter, suggesting scoring errors rather than subjective differences.