RT Journal Article
T1 Effectiveness and costs of phototest in dementia and cognitive impairment screening
A1 Carnero-Pardo, Cristobal
A1 Espejo-Martinez, Beatriz
A1 Lopez-Alcalde, Samuel
A1 Espinosa-Garcia, Maria
A1 Saez-Zea, Carmen
A1 Vilchez-Carrillo, Rosa
A1 Hernandez-Torres, Elisa
A1 Navarro-Espigares, Jose L
K1 Trastornos del Conocimiento
K1 Demencia
K1 Femenino
K1 Humanos
K1 Masculino
K1 Tamizaje Masivo
K1 Pruebas Neuropsicológicas
K1 Anciano
K1 Ancianos de 80 o más años
AB BACKGROUNDTo assess and compare the effectiveness and costs of Phototest, Mini Mental State Examination (MMSE), and Memory Impairment Screen (MIS) to screen for dementia (DEM) and cognitive impairment (CI).METHODSA phase III study was conducted over one year in consecutive patients with suspicion of CI or DEM at four Primary Care (PC) centers. After undergoing all screening tests at the PC center, participants were extensively evaluated by researchers blinded to screening test results in a Cognitive-Behavioral Neurology Unit (CBNU). The gold standard diagnosis was established by consensus of expert neurologists. Effectiveness was assessed by the proportion of correct diagnoses (diagnostic accuracy [DA]) and by the kappa index of concordance between test results and gold standard diagnoses. Costs were based on public prices and hospital accounts.RESULTSThe study included 140 subjects (48 with DEM, 37 with CI without DEM, and 55 without CI). The MIS could not be applied to 23 illiterate subjects (16.4%). For DEM, the maximum effectiveness of the MMSE was obtained with different cutoff points as a function of educational level [k = 0.31 (95% Confidence interval [95%CI], 0.19-0.43), DA = 0.60 (95%CI, 0.52-0.68)], and that of the MIS with a cutoff of 3/4 [k = 0.63 (95%CI, 0.48-0.78), DA = 0.83 (95%CI, 0.80-0.92)]. Effectiveness of the Phototest [k = 0.71 (95%CI, 0.59-0.83), DA = 0.87 (95%CI, 0.80-0.92)] was similar to that of the MIS and higher than that of the MMSE. Costs were higher with MMSE (275.9 ± 193.3€ [mean ± sd euros]) than with Phototest (208.2 ± 196.8€) or MIS (201.3 ± 193.4€), whose costs did not significantly differ. For CI, the effectiveness did not significantly differ between MIS [k = 0.59 (95%CI, 0.45-0.74), DA = 0.79 (95%CI, 0.64-0.97)] and Phototest [k = 0.58 (95%CI, 0.45-0.74), DA = 0.78 (95%CI, 0.64-0.95)] and was lowest for the MMSE [k = 0.27 (95%CI, 0.09-0.45), DA = 0.69 (95%CI, 0.56-0.84)]. Costs were higher for MMSE (393.4 ± 121.8€) than for Phototest (287.0 ± 197.4€) or MIS (300.1 ± 165.6€), whose costs did not significantly differ.CONCLUSIONMMSE is not an effective instrument in our setting. For both DEM and CI, the Phototest and MIS are more effective and less costly, with no difference between them. However, MIS could not be applied to the appreciable percentage of our population who were illiterate.
PB BioMed Central
YR 2011
FD 2011-07-09
LK http://hdl.handle.net/10668/642
UL http://hdl.handle.net/10668/642
LA en
NO Carnero-Pardo C, Espejo-Martinez B, Lopez-Alcalde S, Espinosa-Garcia M , Saez-Zea C, Vilchez-Carrillo R et al. Effectiveness and costs of phototest in dementia and cognitive impairment screening. BMC Neurol. 2011 Jul 29;11:92.
NO Clinical Trial, Phase III; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't;
DS RISalud
RD Apr 10, 2025