Current Alzheimer Research ( IF 1.8 ) Pub Date : 2020-03-31 , DOI: 10.2174/1567205017999200626201121 Emma Elliott 1 , Claire Green 1 , David J Llewellyn 2 , Terence J Quinn 1
Background: Telephone-based cognitive assessments may be preferable to in-person testing in terms of test burden, economic and opportunity cost.
Objective: We sought to determine the accuracy of telephone-based screening for the identification of dementia or Mild Cognitive Impairment (MCI).
Methods: Five multidisciplinary databases were searched. Two researchers independently screened articles and extracted data. Eligible studies compared any multi-domain telephone-based assessment of cognition to the face-to-face diagnostic evaluation. Where data allowed, we pooled test accuracy metrics using the bivariate approach.
Results: From 11,732 titles, 34 papers were included, describing 15 different tests. There was variation in test scoring and quality of included studies. Pooled analyses of accuracy for dementia: Telephone Interview for Cognitive Status (TICS) (<31/41) sensitivity: 0.92, specificity: 0.66 (6 studies); TICSmodified (<28/50) sensitivity: 0.91, specificity: 0.91 (3 studies). For MCI: TICS-modified (<33/50) sensitivity: 0.82, specificity: 0.87 (3 studies); Telephone-Montreal Cognitive Assessment (<18/22) sensitivity: 0.98, specificity: 0.69 (2 studies).
Conclusion: There is limited diagnostic accuracy evidence for the many telephonic cognitive screens that exist. The TICS and TICS-m have the greatest supporting evidence; their test accuracy profiles make them suitable as initial cognitive screens where face to face assessment is not possible.
中文翻译:
基于电话的认知筛查测试的准确性:系统评价和元分析。
背景:在测试负担、经济和机会成本方面,基于电话的认知评估可能比面对面测试更可取。
目标:我们试图确定基于电话的筛查在识别痴呆或轻度认知障碍 (MCI) 方面的准确性。
方法:检索了五个多学科数据库。两名研究人员独立筛选文章并提取数据。符合条件的研究将任何基于电话的多领域认知评估与面对面的诊断评估进行了比较。在数据允许的情况下,我们使用双变量方法合并测试准确性指标。
结果:从 11,732 个标题中,包括 34 篇论文,描述了 15 种不同的测试。测试评分和纳入研究的质量存在差异。痴呆症准确性的汇总分析:认知状态电话访谈 (TICS) (<31/41) 敏感性:0.92,特异性:0.66(6 项研究);TICS 修正 (<28/50) 敏感性:0.91,特异性:0.91(3 项研究)。对于 MCI:TICS 修正 (<33/50) 敏感性:0.82,特异性:0.87(3 项研究);电话-蒙特利尔认知评估 (<18/22) 敏感性:0.98,特异性:0.69(2 项研究)。
结论:存在的许多电话认知屏幕的诊断准确性证据有限。TICS 和 TICS-m 有最大的支持证据;他们的测试准确性配置文件使其适合作为无法进行面对面评估的初始认知屏幕。