On the validity of single tests, two-test combinations and the full Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in detecting patients with cognitive impairment.


Journal

Multiple sclerosis (Houndmills, Basingstoke, England)
ISSN: 1477-0970
Titre abrégé: Mult Scler
Pays: England
ID NLM: 9509185

Informations de publication

Date de publication:
12 2020
Historique:
pubmed: 20 11 2019
medline: 25 9 2021
entrez: 20 11 2019
Statut: ppublish

Résumé

The international standard to screen for cognitive impairment in multiple sclerosis (MS) is BICAMS (Brief International Cognitive Assessment for MS). However, with an application time of approximately 20 minutes, the battery might be too time consuming from a pragmatic perspective of a routine examination. To examine the relative sensitivity and specificity of a BICAMS short version and its validity compared to the total battery. The German BICAMS version was applied comprising the Symbol Digit Modalities Test (SDMT), the Brief Visuospatial Memory Test-Revised (BVMT-R) and the Rey Auditory Verbal Learning Test (RAVLT; German VLMT). Single tests and two-test combinations were compared regarding conformity with the total battery. Examining 1320 MS patients, the two-test combination of SDMT-BVMT-R was the most sensitive (92.7%) to impairment and showed the strongest agreement with the total battery (κ = 0.95). Performing binary logistic regression analyses, this combination was also validated by its association with employment status. Application of the total BICAMS battery should be the goal to strive for. However, in time-restricted clinical settings, the combined application of SDMT and BVMT-R is a recommendable alternative with an application time of 10 minutes, while single tests alone are not sufficiently sensitive.

Sections du résumé

BACKGROUND
The international standard to screen for cognitive impairment in multiple sclerosis (MS) is BICAMS (Brief International Cognitive Assessment for MS). However, with an application time of approximately 20 minutes, the battery might be too time consuming from a pragmatic perspective of a routine examination.
OBJECTIVES
To examine the relative sensitivity and specificity of a BICAMS short version and its validity compared to the total battery.
METHODS
The German BICAMS version was applied comprising the Symbol Digit Modalities Test (SDMT), the Brief Visuospatial Memory Test-Revised (BVMT-R) and the Rey Auditory Verbal Learning Test (RAVLT; German VLMT). Single tests and two-test combinations were compared regarding conformity with the total battery.
RESULTS
Examining 1320 MS patients, the two-test combination of SDMT-BVMT-R was the most sensitive (92.7%) to impairment and showed the strongest agreement with the total battery (κ = 0.95). Performing binary logistic regression analyses, this combination was also validated by its association with employment status.
CONCLUSION
Application of the total BICAMS battery should be the goal to strive for. However, in time-restricted clinical settings, the combined application of SDMT and BVMT-R is a recommendable alternative with an application time of 10 minutes, while single tests alone are not sufficiently sensitive.

Identifiants

pubmed: 31741425
doi: 10.1177/1352458519887897
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1919-1928

Auteurs

Sharon Jean Baetge (SJ)

COGITO Center for Applied Neurocognition and Neuropsychological Research, Düsseldorf, Germany.

Melanie Filser (M)

COGITO Center for Applied Neurocognition and Neuropsychological Research, Düsseldorf, Germany.

Alina Renner (A)

COGITO Center for Applied Neurocognition and Neuropsychological Research, Düsseldorf, Germany.

Sebastian Ullrich (S)

05 Statistikberatung, Düsseldorf, Germany.

Christoph Lassek (C)

Neurological Group Practice, Kassel, Germany.

Iris-Katharina Penner (IK)

COGITO Center for Applied Neurocognition and Neuropsychological Research, Düsseldorf, Germany/Department of Neurology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.

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Classifications MeSH