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

Autor:	Kent K; Schulich Medical School at Western University, London., Adly Ibrahim N; Department of Psychology, University of Windsor, Windsor, ON, Canada., Romero K; Department of Psychology, University of Windsor, Windsor, ON, Canada., Baker S; Schulich Medical School at Western University, London., Greenacre M; Schulich Medical School at Western University, London., Boucher CM; Department of Psychology, University of Windsor, Windsor, ON, Canada., Roth RM; Department of Psychiatry, Dartmouth Health, Lebanon, NH., Erdodi LA; Department of Psychology, University of Windsor, Windsor, ON, Canada.; Star UBB Institute, Babeș-Bolyai University, M. Kogalniceanu St 1, Cluj-Napoca, Romania.
Jazyk:	angličtina
Zdroj:	Alzheimer disease and associated disorders [Alzheimer Dis Assoc Disord] 2024 Jan-Mar 01; Vol. 38 (1), pp. 98-100. Date of Electronic Publication: 2024 Jan 29.
DOI:	10.1097/WAD.0000000000000609
Abstrakt:	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. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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