Background/Aims: Since screening and diagnostic tests for dementia do not have perfect accuracy, #x3e;1 test is often administered when assessing patients with cognitive complaints. Use of both patient performance tests and informant questionnaires has been recommended. Combination of individual test results may be based on methods originally defined by Thomas Bayes (revision or updating of pretest probabilities to post-test probabilities given the test results) and by George Boole (application of associative “AND” or “OR” operator). This study sought to apply these methods in clinical practice. Methods: Using the dataset of a pragmatic test accuracy study of the Six-Item Cognitive Impairment Test (6CIT) and informant Ascertain Dementia 8 (AD8), post-test probabilities for the combination were calculated using Bayes’ formula and compared to Boolean “AND” combination. Combined test sensitivity and specificity was calculated using either Boolean “AND” or “OR” operator and compared to results using equations based on individual test sensitivity and specificity. Results: Both Bayesian and Boolean methods produced similar improvements from pretest probability (0.288) to combined post-test probability for dementia (≈0.5). Likewise, the 2 different methods for calculating combined sensitivities and specificities gave similar results, with, as anticipated, the “AND” combination improving overall specificity (to ≈0.65) whereas the “OR” combination improved sensitivity (to ≈1.00). Conclusion: Combination of individual screening test results using Bayesian and Boolean methods is relatively straightforward and may add to clinicians’ intuitive judgements when combining test results.
Dement Geriatr Cogn Disord

中文翻译：

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结合基于性能和 Informant 测试精度研究的结果：贝叶斯还是布尔值？

背景/目的：由于痴呆症的筛查和诊断测试并不具有完美的准确性，因此在评估有认知问题的患者时通常会进行 #x3e;1 测试。建议同时使用患者表现测试和线人问卷。单个测试结果的组合可能基于最初由 Thomas Bayes（根据测试结果将前测概率修订或更新为后测概率）和 George Boole（关联“AND”或“OR”运算符的应用）定义的方法。本研究试图将这些方法应用于临床实践。方法：使用六项认知障碍测试 (6CIT) 和线人 Ascertain Dementia 8 (AD8) 的语用测试准确性研究数据集，使用贝叶斯公式计算组合的测试后概率，并与布尔“AND”组合进行比较. 使用布尔“AND”或“OR”运算符计算组合测试灵敏度和特异性，并使用基于个体测试灵敏度和特异性的方程式与结果进行比较。结果：贝叶斯和布尔方法都产生了类似的改进，从前测概率 (0.288) 到痴呆的组合后测概率 (≈0.5)。同样，计算组合敏感性和特异性的 2 种不同方法给出了相似的结果，正如预期的那样，“AND”组合提高了整体特异性（至 ≈0.65），而“OR”组合提高了敏感性（至 ≈1.00）。结论：使用贝叶斯和布尔方法组合单个筛选测试结果相对简单，并且在组合测试结果时可以增加临床医生的直观判断。
老年痴呆症认知障碍