Spectrum Effect and Spectrum Bias in the Screening Test Performance for Amnestic Mild Cognitive Impairment: What are the Clinical Implications?

Chopard, Gilles; Puyraveau, Marc; Binetruy, Mickael; Meyer, Agatha; Vandel, Pierre; Magnin, Éloi; Berger, Ėric; Galmiche, Jean; Mauny, Frédéric

doi:10.3233/jad-150195

Cited by 5 publications

(3 citation statements)

References 39 publications

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“…As participants were a homogenous sample (older Irish Caucasians), attending a single center (a university hospital memory clinic), there is the potential that spectrum bias may reduce the external validity. These effects have been found for patients with MCI and are particularly affected by age and education [ 62 ]. As presented in Table 3 , participants’ age and education were seen to affect the sensitivity and specificity of both the MoCA and Q mci screen.…”

Section: Discussionmentioning

confidence: 99%

Screening for Mild Cognitive Impairment: Comparison of “MCI Specific” Screening Instruments

Ó’Caoimh

Timmons

Molloy

2016

JAD

100

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Background:Sensitive and specific instruments are required to screen for cognitive impairment (CI) in busy clinical practice. The Montreal Cognitive Assessment (MoCA) is widely validated but few studies compare it to tests designed specifically to detect mild cognitive impairment (MCI).Objective:Comparison of two “MCI specific” screens: the Quick Mild Cognitive Impairment screen (Qmci) and MoCA.Methods:Patients with subjective memory complaints (SMC; n = 73), MCI (n = 103), or dementia (n = 274), were referred to a university hospital memory clinic and underwent comprehensive assessment. Caregivers, without cognitive symptoms, were recruited as normal controls (n = 101).Results:The Qmci was more accurate than the MoCA in differentiating MCI from controls, area under the curve (AUC) of 0.90 versus 0.80, p = 0.009. The Qmci had greater (AUC 0.81), albeit non-significant, accuracy than the MoCA (AUC 0.73) in separating MCI from SMC, p = 0.09. At its recommended cut-off (<62/100), the Qmci had a sensitivity of 90% and specificity of 87% for CI (MCI/dementia). Raising the cut-off to <65 optimized sensitivity (94%), reducing specificity (80%). At <26/30 the MoCA had better sensitivity (96%) but poor specificity (58%). A MoCA cut-off of <24 provided the optimal balance. Median Qmci administration time was 4.5 (±1.3) minutes compared with 9.5 (±2.8) for the MoCA.Conclusions:Although both tests distinguish MCI from dementia, the Qmci is particularly accurate in separating MCI from normal cognition and has shorter administration times, suggesting it is more useful in busy hospital clinics. This study reaffirms the high sensitivity of the MoCA but suggests a lower cut-off (<24) in this setting.

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Section: Discussionmentioning

confidence: 99%

Screening for Mild Cognitive Impairment: Comparison of “MCI Specific” Screening Instruments

Ó’Caoimh

Timmons

Molloy

2016

JAD

100

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“…Third, this was a highly selected sample with those found to have clinical depression and those with atypical presentations excluded as they often present with exaggerated functional and cognitive impairments. Fourth, given the relatively homogenous sample, spectrum bias may have occurred further limiting the results (Chopard et al, 2015). Finally, cognitively healthy (asymptomatic age-matched with normal neuropsychological testing) controls were not included in this analysis.…”

Section: Limitationsmentioning

confidence: 99%

Screening for Cognitive Frailty Using Short Cognitive Screening Instruments: Comparison of the Chinese Versions of the MoCA and Qmci Screen

Lin

et al. 2020

Front. Psychol.

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Background: Cognitive frailty describes cognitive impairment associated with physical decline. Few studies have explored whether short cognitive screens identify frailty. We examined the diagnostic accuracy of the Chinese versions of the Quick Mild Cognitive Impairment (Qmci-CN) screen and Montreal Cognitive Assessment (MoCA-CN) in identifying cognitive frailty. Methods: Ninety-five participants with cognitive symptoms [47 with mild cognitive impairment (MCI), 34 with subjective cognitive disorder, and 14 with dementia] were included from two outpatient rehabilitation clinics. Energy (work intensity) and physical activity levels were recorded. Cognitive frailty was diagnosed by an interdisciplinary team using the IANA/IAGG consensus criteria, stratified on the Clinical Frailty Scale (CFS). Instruments were administered sequentially and randomly by trained assessors, blind to the diagnosis. Results: The mean age of the sample was 62.6 ± 10.2 years; median CFS score was 4 ± 1 and 36 (38%) were cognitively frail. The Qmci-CN had similar accuracy in differentiating the non-frail from cognitively frail compared to the MoCA-CN, AUC 0.82 versus 0.74, respectively (p = 0.19). At its optimal cutoff (≤55/100), the Qmci-CN provided a sensitivity of 83% and specificity of 67% versus 91% and 51%, respectively, for the MoCA-CN (≤23/30). Neither was accurate in separating MCI from cognitive frailty but both accurately separated cognitive frailty from dementia.

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“…This allows the identification of active components in TCM, and the formulation of standards to assess their internal quality (19). The spectrum-effect relationship has also been applied in multi-field research, such as single herb treatment, classic couplet medicines, compound compatibility, processing mechanism and technology optimization (20)(21)(22)(23)(24). In addition, it can be used to identify key substances, optimize the ratio of ingredients, improve preparation technology and track various characteristics, providing insight into novel approaches for the development of novel TCM drugs (19,(25)(26)(27)(28)(29)(30)(31).…”

Section: Identification Of Compounds With Antipyretic Effectsmentioning

confidence: 99%

Identification of compounds with antipyretic effects and anti‑endotoxin activity in different species of Lonicera japonica using spectrum‑effect correlation

Ding

Liu

et al. 2021

Exp Ther Med

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Spectrum Effect and Spectrum Bias in the Screening Test Performance for Amnestic Mild Cognitive Impairment: What are the Clinical Implications?

Abstract: These findings could potentially affect the clinician's decision with a possible greater impact in elderly patients with a lower educational level.

Cited by 5 publications

References 39 publications

Screening for Mild Cognitive Impairment: Comparison of “MCI Specific” Screening Instruments

Screening for Mild Cognitive Impairment: Comparison of “MCI Specific” Screening Instruments

Screening for Cognitive Frailty Using Short Cognitive Screening Instruments: Comparison of the Chinese Versions of the MoCA and Qmci Screen

Identification of compounds with antipyretic effects and anti‑endotoxin activity in different species of Lonicera japonica using spectrum‑effect correlation

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