Compassion Versus Accuracy: Lenient Scoring of the Spatial Orientation Items on the Mini-mental State Exam Lowers Sensitivity.

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Alzheimer Disease & Associated Disorders Pub Date : 2024-01-01 Epub Date: 2024-01-29 DOI:10.1097/WAD.0000000000000609

Katrina Kent, Nesrine Adly Ibrahim, Kristoffer Romero, Shannon Baker, Matthew Greenacre, Chantal M Boucher, Robert M Roth, Laszlo A Erdodi

{"title":"Compassion Versus Accuracy: Lenient Scoring of the Spatial Orientation Items on the Mini-mental State Exam Lowers Sensitivity.","authors":"Katrina Kent, Nesrine Adly Ibrahim, Kristoffer Romero, Shannon Baker, Matthew Greenacre, Chantal M Boucher, Robert M Roth, Laszlo A Erdodi","doi":"10.1097/WAD.0000000000000609","DOIUrl":null,"url":null,"abstract":"<p><p>The Mini-mental State Examination (MMSE) is a commonly used screening tool for cognitive impairment. Lenient scoring of spatial orientation errors (SOEs) on the MMSE is common and negatively affects its diagnostic utility. We examined the effect of lenient SOE scoring on MMSE classification accuracy in a consecutive case series of 103 older adults (age 60 or above) clinically referred for neuropsychological evaluation. Lenient scoring of SOEs on the MMSE occurred in 53 (51.4%) patients and lowered the sensitivity by 7% to 18%, with variable gains in specificity (0% to 11%) to psychometrically operationalized cognitive impairment. Results are consistent with previous reports that lenient scoring is widespread and attenuates the sensitivity of the MMSE. Given the higher clinical priority of correctly detecting early cognitive decline over specificity, a warning against lenient scoring of SOEs (on the MMSE and other screening tools) during medical education and in clinical practice is warranted.</p>","PeriodicalId":7679,"journal":{"name":"Alzheimer Disease & Associated Disorders","volume":" ","pages":"98-100"},"PeriodicalIF":1.8000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alzheimer Disease & Associated Disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/WAD.0000000000000609","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/29 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

The Mini-mental State Examination (MMSE) is a commonly used screening tool for cognitive impairment. Lenient scoring of spatial orientation errors (SOEs) on the MMSE is common and negatively affects its diagnostic utility. We examined the effect of lenient SOE scoring on MMSE classification accuracy in a consecutive case series of 103 older adults (age 60 or above) clinically referred for neuropsychological evaluation. Lenient scoring of SOEs on the MMSE occurred in 53 (51.4%) patients and lowered the sensitivity by 7% to 18%, with variable gains in specificity (0% to 11%) to psychometrically operationalized cognitive impairment. Results are consistent with previous reports that lenient scoring is widespread and attenuates the sensitivity of the MMSE. Given the higher clinical priority of correctly detecting early cognitive decline over specificity, a warning against lenient scoring of SOEs (on the MMSE and other screening tools) during medical education and in clinical practice is warranted.

查看原文本刊更多论文

同情心与准确性：小型精神状态测验空间定向项目的宽松评分降低了灵敏度。

迷你精神状态检查（MMSE）是一种常用的认知障碍筛查工具。在 MMSE 中对空间方位错误（SOE）进行宽松评分的情况很常见，这对其诊断效用产生了负面影响。我们对 103 名临床转诊进行神经心理评估的老年人（60 岁或以上）进行了连续病例系列研究，考察了空间定向错误评分过宽对 MMSE 分类准确性的影响。53例（51.4%）患者的MMSE中出现了SOE评分宽松的情况，灵敏度降低了7%至18%，对心理测量操作认知障碍的特异性也有不同程度的提高（0%至11%）。结果与之前的报告一致，即宽松评分是普遍现象，会降低 MMSE 的灵敏度。鉴于临床上正确检测早期认知功能衰退比特异性更重要，因此在医学教育和临床实践中应警惕对SOE（MMSE和其他筛查工具）的宽松评分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Alzheimer Disease & Associated Disorders 医学-病理学

CiteScore

3.10

自引率

4.80%

发文量

期刊介绍： Alzheimer Disease & Associated Disorders is a peer-reviewed, multidisciplinary journal directed to an audience of clinicians and researchers, with primary emphasis on Alzheimer disease and associated disorders. The journal publishes original articles emphasizing research in humans including epidemiologic studies, clinical trials and experimental studies, studies of diagnosis and biomarkers, as well as research on the health of persons with dementia and their caregivers. The scientific portion of the journal is augmented by reviews of the current literature, concepts, conjectures, and hypotheses in dementia, brief reports, and letters to the editor.