A statistical approach for classifying change in cognitive function in individuals following pharmacologic challenge: an example with alprazolam

Maruff, Paul; Werth, John; Giordani, Bruno; Caveney, Angela F.; Feltner, Douglas E.; Snyder, Peter J.

doi:10.1007/s00213-006-0331-5

Cited by 39 publications

(32 citation statements)

References 27 publications

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“…Negative effect size indicates poorer performance in post-procedure than in pre-procedure testing At hospital discharge, patients in this study were cognitively impaired with reduced speed of response and task accuracy, as measured by the Cogstate brief test battery, which is similar to previous studies. [10][11][12][13][14] These results did not differ between patients with light vs deep sedation; consequently, while light sedation might confer logistic advantages, they cannot be extended to cognitive improvement at hospital discharge. Patients were not retested; thus, no conclusions can be made between the light and deep sedation groups regarding the speed or completeness of recovery to baseline cognition.…”

Section: Discussionmentioning

confidence: 75%

“…22 A reliable change index (RCI) for each patient for the detection task in the Cogstate test battery was calculated to quantify clinically significant cognitive decline. The RCI allows for assessment of impairment from baseline testing at the individual patient level 14 and has been used to assess post-sedation recovery. 20 It is calculated by obtaining the task speed at discharge, subtracting the task speed at baseline, and dividing by the within-subject SD.…”

Section: Discussionmentioning

confidence: 99%

“…An index [ 1 has been calculated as impairment equivalent to a blood alcohol concentration of 0.05%. 13,14 The Kruskal-Wallis rank test was used to compare sedation satisfaction between the two patient groups, the anesthesiologists, and the endoscopists. All recorded P values are two-sided.…”

Section: Discussionmentioning

confidence: 99%

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A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery

Allen

Leslie

Hebbard

et al. 2015

Can J Anesth/J Can Anesth

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A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery Une étude randomisée contrôlée sur la sédation légère vs profonde au propofol pour la colonoscopie non urgente en ambulatoire: le souvenir, les conditions entourant l'intervention et la récupération sedation; P \ 0.0001). The incidence of recall was 12% in the light sedation group and 1% in the deep sedation group. The risk difference for recall was 0.11 (90% confidence interval, 0.05 to 0.17) in the intention-to-treat analysis, thus refuting equivalence in recall between light and deep sedation (0.05 significance level; 10% equivalence margin). Overall sedation-related complications were more frequent with deep sedation than with light sedation (66% vs 47%, respectively; P = 0.008). Recovery was more rapid with light sedation than with deep sedation as determined by the mean (SD) time to reach a score of 5 on the Modified Observer's Assessment of Alertness/Sedation Scale [3 (4) min vs 7 (4) min, respectively; P \ 0.001] and by the median [IQR] time to min, respectivement; P = 0.001). L'incidence des troubles cognitifs post-procéduraux était semblable chez les personnes randomisées à recevoir une sédation légère (19 %) ou profonde (16 %) (P = 0,554). Conclusion La sédation légère n'était pas équivalente à la sédation profonde en matière de souvenir de l'intervention, du spectre de complications ou des temps de récupération. Cette étude procure des données probantes nécessaires pour informer les patients concernant la sédation pour la colonoscopie. Cette étude a été enregistrée au Registre australien et néozélandais des études cliniques, no. 12611000320954.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery

Allen

Leslie

Hebbard

et al. 2015

Can J Anesth/J Can Anesth

Self Cite

View full text Add to dashboard Cite

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“…A base 10 logarithmic transformation was then applied to normalize the distributions of mean RT. On the basis of prior studies [38][39][40] , the performance in each task was defined by a single outcome measure. Speed of performance was used for the DET, IDN and OBK tasks, and accuracy of performance for the OCL task.…”

Section: Identification Taskmentioning

confidence: 99%

Evaluation of the Usability of a Brief Computerized Cognitive Screening Test in Older People for Epidemiological Studies

Fredrickson¹,

Maruff²,

et al. 2009

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Background: Computerized cognitive testing has the potential to be an effective way to assess and monitor cognition in large neuroepidemiological studies. CogState is a game-like computerized test with demonstrated validity and reliability that has shown sensitivity to decline in older individuals over time. This study aimed to evaluate the serial usability of the test specifically within an older community cohort. Methods: The test battery was administered to healthy volunteers aged 50 years and above at 3-month intervals over 12 months in a community setting. Test usability was examined in terms of acceptability, efficiency and stability. Results: Of 301 subjects (age: 61.9 ± 7.2 years), 87% completed the study. In addition, 85% completed the first test within the allowed time and passed integrity criteria with their performance improving and stabilizing at subsequent visits. The computerized battery required 15 min for administration on average, allowing 263 patients to be assessed on 5 occasions by 2 assessors. All tasks showed stability and a high test-retest reliability with serial administration. Conclusions: This computerized test was shown to have good acceptability, efficiency and stability for the repeated assessment of cognitive function in older people. Together with its demonstrated sensitivity to cognitive impairment and cognitive change, these data suggest that it would be a useful tool for application in neuroepidemiological studies.

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“…Efficacy evaluations included the ADAS-Cog 75, ADAS-Cog 70 [36], NPI [35], Clinical Global Impression-Improvement (CGI-I) [37] and selected subtests (detection, identification, visual learning, one-back working memory and the continuous paired associate learning task) from the CogState Neuropsychological Assessment Battery [38]. A certified rater was required for the administration of the ADAS-Cog, NPI and MMSE [33].…”

Section: Methodsmentioning

confidence: 99%

Phase II Crossover Trial of Varenicline in Mild-to-Moderate Alzheimer's Disease

Kim¹,

Choi²,

Rollema³

et al. 2013

Dement Geriatr Cogn Disord

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Background: Evidence supports a role of α4β2 receptors in Alzheimer's disease (AD). Methods: This Korean, multicenter, double-blind, two-period (6 weeks each), crossover study randomized participants to the order in which they received varenicline (1 mg twice daily) and placebo. Assessments included AD Assessment Scale-Cognitive Subscale (ADAS-Cog) 75, Neuropsychiatric Inventory (NPI), adverse events (AEs) and Columbia-Suicide Severity Rating Scale (C-SSRS). Results: For varenicline versus placebo (n = 66 randomized), there was no significant difference in the week 6 least square (LS) mean ADAS-Cog 75 total score (primary endpoint; 18.07 vs. 18.49; p = 0.3873) and a slight worsening in the week 6 LS mean NPI (3.82 vs. 2.55; p = 0.0468), primarily driven by decreased appetite/eating. Common treatment-related AEs were nausea (23.3; 3.4%), vomiting (15.0%; 0) and decreased appetite (15.0; 6.8%). Conclusions: Varenicline did not improve cognition, behavior or global change in this population. The most frequent varenicline-associated AEs were gastrointestinal; psychiatric AEs were rare and similar between the groups.

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A statistical approach for classifying change in cognitive function in individuals following pharmacologic challenge: an example with alprazolam

Abstract: These findings, although preliminary, suggest that statistically reliable decisions about the effects of sedative drugs on cognition can be made for individuals.

Cited by 39 publications

References 27 publications

A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery

A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery

Evaluation of the Usability of a Brief Computerized Cognitive Screening Test in Older People for Epidemiological Studies

Phase II Crossover Trial of Varenicline in Mild-to-Moderate Alzheimer's Disease

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