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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
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Screening for HIV-Associated Neurocognitive Disorders: Sensitivity and Specificity.
Reuben N Robbins1, Travis M Scott2,3, Hetta Gouse4
1HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Medical Center, New York, NY, USA. rnr2110@cumc.columbia.edu.
Current Topics in Behavioral Neurosciences
|July 18, 2020
Summary
HIV-associated neurocognitive disorder (HAND) screening is recommended but not routinely performed. This review examines current HAND screening tests, highlighting challenges in detecting mild forms and their suitability for global use.
Area of Science:
- Neuroscience
- Infectious Diseases
- Public Health
Background:
- HIV-associated neurocognitive disorder (HAND) is a common complication in people living with HIV (PLWH), persisting even with effective antiretroviral therapy.
- Early detection and management of HAND are crucial for improving patient outcomes and adjusting treatment regimens.
- Current clinical practice lacks standardized guidelines for HAND screening, including recommended timing and specific diagnostic tools.
Purpose of the Study:
- To review recent research on screening tests designed for the early detection of HAND.
- To critically evaluate the strengths, limitations, and psychometric properties of available HAND screening tools.
- To identify challenges in accurately diagnosing mild forms of HAND and assess the feasibility of current tools in resource-limited settings.
Main Methods:
- Systematic literature review of recent research on HAND screening tests.
- Analysis of the diagnostic accuracy, sensitivity, and specificity of various screening instruments.
- Evaluation of the practical requirements for administering and scoring HAND tests, including the need for specialized healthcare professionals.
Main Results:
- Existing screening tools often struggle to accurately identify mild HAND, potentially leading to underdiagnosis.
- Many HAND screening tests require extensive training and resources, limiting their applicability in low- and middle-income countries.
- Significant variability exists in the psychometric properties and clinical utility of different HAND screening methods.
Conclusions:
- There is a critical need for validated, accessible, and sensitive screening tools for HAND, particularly for mild cognitive impairments.
- Development and implementation of guidelines for routine HAND screening are essential for effective management of PLWH.
- Future research should focus on creating user-friendly and accurate screening methods suitable for diverse global healthcare settings.
