دورية أكاديمية
أعرض في EDS

Mini-Cog for the detection of dementia within a secondary care setting.

التفاصيل البيبلوغرافية
العنوان: Mini-Cog for the detection of dementia within a secondary care setting.
المؤلفون: Chan CC; School of Medicine, Queen's University, Kingston, Canada., Fage BA; Department of Psychiatry, University of Toronto, Toronto, Canada., Burton JK; Academic Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK., Smailagic N; Institute of Public Health, University of Cambridge , Cambridge, UK., Gill SS; Department of Medicine, Queen's University, Kingston, Canada., Herrmann N; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Canada., Nikolaou V; Research In Real Life , Cambridge , UK., Quinn TJ; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK., Noel-Storr AH; Radcliffe Department of Medicine, University of Oxford , Oxford, UK., Seitz DP; Department of Psychiatry, Queen's University, Kingston, Canada.
المصدر: The Cochrane database of systematic reviews [Cochrane Database Syst Rev] 2021 Jul 14; Vol. 7. Cochrane AN: CD011414. Date of Electronic Publication: 2021 Jul 14.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't; Systematic Review
اللغة: English
بيانات الدورية: Publisher: Wiley Country of Publication: England NLM ID: 100909747 Publication Model: Electronic Cited Medium: Internet ISSN: 1469-493X (Electronic) Linking ISSN: 13616137 NLM ISO Abbreviation: Cochrane Database Syst Rev Subsets: MEDLINE
أسماء مطبوعة: Publication: 2004- : Chichester, West Sussex, England : Wiley
Original Publication: Oxford, U.K. ; Vista, CA : Update Software,
مواضيع طبية MeSH: Secondary Care*, Alzheimer Disease/*diagnosis , Cognition Disorders/*diagnosis , Dementia/*diagnosis , Mental Status and Dementia Tests/*standards, Aged ; Aged, 80 and over ; Bias ; Cross-Sectional Studies ; Dementia/epidemiology ; Diagnosis, Differential ; Disease Progression ; Humans ; Patient Selection ; Prevalence ; Sensitivity and Specificity
مستخلص: Background: The diagnosis of Alzheimer's disease dementia and other dementias relies on clinical assessment. There is a high prevalence of cognitive disorders, including undiagnosed dementia in secondary care settings. Short cognitive tests can be helpful in identifying those who require further specialist diagnostic assessment; however, there is a lack of consensus around the optimal tools to use in clinical practice. The Mini-Cog is a short cognitive test comprising three-item recall and a clock-drawing test that is used in secondary care settings.
Objectives: The primary objective was to determine the accuracy of the Mini-Cog for detecting dementia in a secondary care setting. The secondary objectives were to investigate the heterogeneity of test accuracy in the included studies and potential sources of heterogeneity. These potential sources of heterogeneity will include the baseline prevalence of dementia in study samples, thresholds used to determine positive test results, the type of dementia (Alzheimer's disease dementia or all causes of dementia), and aspects of study design related to study quality.
Search Methods: We searched the following sources in September 2012, with an update to 12 March 2019: Cochrane Dementia Group Register of Diagnostic Test Accuracy Studies, MEDLINE (OvidSP), Embase (OvidSP), BIOSIS Previews (Web of Knowledge), Science Citation Index (ISI Web of Knowledge), PsycINFO (OvidSP), and LILACS (BIREME). We made no exclusions with regard to language of Mini-Cog administration or language of publication, using translation services where necessary.
Selection Criteria: We included cross-sectional studies and excluded case-control designs, due to the risk of bias. We selected those studies that included the Mini-Cog as an index test to diagnose dementia where dementia diagnosis was confirmed with reference standard clinical assessment using standardised dementia diagnostic criteria. We only included studies in secondary care settings (including inpatient and outpatient hospital participants).
Data Collection and Analysis: We screened all titles and abstracts generated by the electronic database searches. Two review authors independently checked full papers for eligibility and extracted data. We determined quality assessment (risk of bias and applicability) using the QUADAS-2 tool. We extracted data into two-by-two tables to allow calculation of accuracy metrics for individual studies, reporting the sensitivity, specificity, and 95% confidence intervals of these measures, summarising them graphically using forest plots.
Main Results: Three studies with a total of 2560 participants fulfilled the inclusion criteria, set in neuropsychology outpatient referrals, outpatients attending a general medicine clinic, and referrals to a memory clinic. Only n = 1415 (55.3%) of participants were included in the analysis to inform evaluation of Mini-Cog test accuracy, due to the selective use of available data by study authors. There were concerns related to high risk of bias with respect to patient selection, and unclear risk of bias and high concerns related to index test conduct and applicability. In all studies, the Mini-Cog was retrospectively derived from historic data sets. No studies included acute general hospital inpatients. The prevalence of dementia ranged from 32.2% to 87.3%. The sensitivities of the Mini-Cog in the individual studies were reported as 0.67 (95% confidence interval (CI) 0.63 to 0.71), 0.60 (95% CI 0.48 to 0.72), and 0.87 (95% CI 0.83 to 0.90). The specificity of the Mini-Cog for each individual study was 0.87 (95% CI 0.81 to 0.92), 0.65 (95% CI 0.57 to 0.73), and 1.00 (95% CI 0.94 to 1.00). We did not perform meta-analysis due to concerns related to risk of bias and heterogeneity.
Authors' Conclusions: This review identified only a limited number of diagnostic test accuracy studies using Mini-Cog in secondary care settings. Those identified were at high risk of bias related to patient selection and high concerns related to index test conduct and applicability. The evidence was indirect, as all studies evaluated Mini-Cog differently from the review question, where it was anticipated that studies would conduct Mini-Cog and independently but contemporaneously perform a reference standard assessment to diagnose dementia. The pattern of test accuracy varied across the three studies. Future research should evaluate Mini-Cog as a test in itself, rather than derived from other neuropsychological assessments. There is also a need for evaluation of the feasibility of the Mini-Cog for the detection of dementia to help adequately determine its role in the clinical pathway.
(Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)
التعليقات: Update of: Cochrane Database Syst Rev. 2019 Sep 14;9:CD011414. doi: 10.1002/14651858.CD011414.pub2. (PMID: 31521064)
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معلومات مُعتمدة: T32 AI118697 United States AI NIAID NIH HHS
تواريخ الأحداث: Date Created: 20210714 Date Completed: 20210812 Latest Revision: 20240829
رمز التحديث: 20240830
مُعرف محوري في PubMed: PMC8278979
DOI: 10.1002/14651858.CD011414.pub3
PMID: 34260060
قاعدة البيانات: MEDLINE
الوصف
تدمد:1469-493X
DOI:10.1002/14651858.CD011414.pub3