The impact of conventional versus robust norming on cognitive characterization and clinical classification of MCI and dementia

IF 2 4区 心理学 Q2 PSYCHOLOGY
Alyssa N. Kaser, David M. Kaplan, William Goette, Andrew M. Kiselica
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引用次数: 2

Abstract

We examined the impact of conventional versus robust normative approaches on cognitive characterization and clinical classification of MCI versus dementia. The sample included participants from the National Alzheimer's Coordinating Center Uniform Data Set. Separate demographically adjusted z-scores for cognitive tests were derived from conventional (n = 4273) and robust (n = 602) normative groups. To assess the impact of deriving scores from a conventional versus robust normative group on cognitive characterization, we examined likelihood of having a low score on each neuropsychological test. Next, we created receiver operating characteristic (ROC) curves for the ability of normed scores derived from each normative group to differentiate between MCI (n = 3570) and dementia (n = 1564). We examined the impact of choice of normative group on classification accuracy by comparing sensitivity and specificity values and areas under the curves (AUC). Compared with using a conventional normative group, using a robust normative group resulted in a higher likelihood of low cognitive scores for individuals classified with MCI and dementia. Comparison of the classification accuracy for distinguishing MCI from dementia did not suggest a statistically significant advantage for either normative approach (Z = −0.29, p = .77; AUC = 0.86 for conventional and AUC = 0.86 for robust). In summary, these results indicate that using a robust normative group increases the likelihood of characterizing cognitive performance as low. However, there is not a clear advantage of using a robust over a conventional normative group when differentiating between MCI and dementia.

传统与稳健规范对轻度认知损伤和痴呆的认知特征和临床分类的影响
我们研究了传统与稳健的规范方法对认知特征和MCI与痴呆的临床分类的影响。样本包括来自国家阿尔茨海默病协调中心统一数据集的参与者。分别从常规(n = 4273)和稳健(n = 602)规范组中得出经人口统计学调整的认知测试z分数。为了评估从常规组和稳健的规范组中获得分数对认知特征的影响,我们检查了在每个神经心理测试中获得低分的可能性。接下来,我们创建了受试者工作特征(ROC)曲线,用于区分每个规范组的标准化评分(n = 3570)和痴呆(n = 1564)的能力。我们通过比较敏感性和特异性值以及曲线下面积(AUC)来检验标准组选择对分类准确性的影响。与使用传统的规范组相比,使用稳健的规范组导致MCI和痴呆个体认知得分低的可能性更高。比较区分轻度认知障碍和痴呆的分类准确度,两种标准方法都没有统计学上的显著优势(Z = - 0.29, p = .77;常规AUC = 0.86,稳健AUC = 0.86)。综上所述,这些结果表明,使用稳健的规范组增加了将认知表现定性为低的可能性。然而,在区分MCI和痴呆时,使用鲁棒组并没有明显的优势。
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来源期刊
Journal of Neuropsychology
Journal of Neuropsychology 医学-心理学
CiteScore
4.50
自引率
4.50%
发文量
34
审稿时长
>12 weeks
期刊介绍: The Journal of Neuropsychology publishes original contributions to scientific knowledge in neuropsychology including: • clinical and research studies with neurological, psychiatric and psychological patient populations in all age groups • behavioural or pharmacological treatment regimes • cognitive experimentation and neuroimaging • multidisciplinary approach embracing areas such as developmental psychology, neurology, psychiatry, physiology, endocrinology, pharmacology and imaging science The following types of paper are invited: • papers reporting original empirical investigations • theoretical papers; provided that these are sufficiently related to empirical data • review articles, which need not be exhaustive, but which should give an interpretation of the state of research in a given field and, where appropriate, identify its clinical implications • brief reports and comments • case reports • fast-track papers (included in the issue following acceptation) reaction and rebuttals (short reactions to publications in JNP followed by an invited rebuttal of the original authors) • special issues.
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