A comparison of five clock scoring methods using ROC (receiver operating characteristic) curve analysis
Objective To compare the accuracy of five clock scoring methods for detecting dementia in English‐speaking patients. Design A prospective cohort study. Setting A general geriatric outpatient clinic in southwest Sydney, Australia. Participants A total of 127 consecutive new referrals to the clinic, o...
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| Veröffentlicht in: | International journal of geriatric psychiatry 2001-04, Vol.16 (4), p.394-399 |
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| creator | Storey, Joella E. Rowland, Jeffrey T. J. Basic, David Conforti, David A. |
| description | Objective
To compare the accuracy of five clock scoring methods for detecting dementia in English‐speaking patients.
Design
A prospective cohort study.
Setting
A general geriatric outpatient clinic in southwest Sydney, Australia.
Participants
A total of 127 consecutive new referrals to the clinic, of mean age 78.2 years.
Measurements
The clock drawing test was conducted at the beginning of each clinic appointment by a blinded observer. Each patient was then assessed by a geriatrician, who collected demographic data, administered the modified Barthel index, the geriatric depression scale, and the Folstein Mini‐Mental State Examination, and categorised each patient as demented or not demented, according to DSM‐4 criteria. Each clock was scored according to the methods of Mendez, Shulman, Sunderland, Watson and Wolf‐Klein, and evaluated for reliability, and predictive accuracy, using receiver operating characteristic (ROC) curve analysis.
Results
The area under the ROC curve was largest for the Shulman (0.79, 95% CI 0.70–0.85) and Mendez (0.78, 95% CI 0.70–0.85) methods. Both predicted dementia more accurately than the Sunderland (area = 0.71) and Watson (area = 0.65) methods (p |
| doi_str_mv | 10.1002/gps.352 |
| format | Article |
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To compare the accuracy of five clock scoring methods for detecting dementia in English‐speaking patients.
Design
A prospective cohort study.
Setting
A general geriatric outpatient clinic in southwest Sydney, Australia.
Participants
A total of 127 consecutive new referrals to the clinic, of mean age 78.2 years.
Measurements
The clock drawing test was conducted at the beginning of each clinic appointment by a blinded observer. Each patient was then assessed by a geriatrician, who collected demographic data, administered the modified Barthel index, the geriatric depression scale, and the Folstein Mini‐Mental State Examination, and categorised each patient as demented or not demented, according to DSM‐4 criteria. Each clock was scored according to the methods of Mendez, Shulman, Sunderland, Watson and Wolf‐Klein, and evaluated for reliability, and predictive accuracy, using receiver operating characteristic (ROC) curve analysis.
Results
The area under the ROC curve was largest for the Shulman (0.79, 95% CI 0.70–0.85) and Mendez (0.78, 95% CI 0.70–0.85) methods. Both predicted dementia more accurately than the Sunderland (area = 0.71) and Watson (area = 0.65) methods (p < 0.05). The inter‐rater (0.81–0.93) and intra‐rater (0.87–0.96) correlation coefficients were high for all five methods.
Conclusions
While substantial differences among the clock scoring methods were evident in our sample, the accuracy of each was modest at best. Unless further studies in relevant settings suggest otherwise, we caution on the use of clock drawing alone to screen for dementia. Copyright © 2001 John Wiley & Sons, Ltd.</description><identifier>ISSN: 0885-6230</identifier><identifier>EISSN: 1099-1166</identifier><identifier>DOI: 10.1002/gps.352</identifier><identifier>PMID: 11333427</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Aged ; Biological and medical sciences ; clock drawing ; Cognition ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; dementia ; Dementia - diagnosis ; Dementia - psychology ; diagnostic accuracy ; Female ; gold standard ; Humans ; Male ; Mass Screening - methods ; Medical sciences ; Neurology ; Neuropsychological Tests - standards ; Observer Variation ; Predictive Value of Tests ; Psychometrics ; Reproducibility of Results ; ROC Curve ; ROC curve analysis ; Tropical medicine</subject><ispartof>International journal of geriatric psychiatry, 2001-04, Vol.16 (4), p.394-399</ispartof><rights>Copyright © 2001 John Wiley & Sons, Ltd.</rights><rights>2001 INIST-CNRS</rights><rights>Copyright 2001 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4762-da30af0e13b896ee5dbe48a9d2ca1c8750878b526d3ab0c5e0c0557e72cba583</citedby><cites>FETCH-LOGICAL-c4762-da30af0e13b896ee5dbe48a9d2ca1c8750878b526d3ab0c5e0c0557e72cba583</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fgps.352$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fgps.352$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=960326$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11333427$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Storey, Joella E.</creatorcontrib><creatorcontrib>Rowland, Jeffrey T. J.</creatorcontrib><creatorcontrib>Basic, David</creatorcontrib><creatorcontrib>Conforti, David A.</creatorcontrib><title>A comparison of five clock scoring methods using ROC (receiver operating characteristic) curve analysis</title><title>International journal of geriatric psychiatry</title><addtitle>Int. J. Geriat. Psychiatry</addtitle><description>Objective
To compare the accuracy of five clock scoring methods for detecting dementia in English‐speaking patients.
Design
A prospective cohort study.
Setting
A general geriatric outpatient clinic in southwest Sydney, Australia.
Participants
A total of 127 consecutive new referrals to the clinic, of mean age 78.2 years.
Measurements
The clock drawing test was conducted at the beginning of each clinic appointment by a blinded observer. Each patient was then assessed by a geriatrician, who collected demographic data, administered the modified Barthel index, the geriatric depression scale, and the Folstein Mini‐Mental State Examination, and categorised each patient as demented or not demented, according to DSM‐4 criteria. Each clock was scored according to the methods of Mendez, Shulman, Sunderland, Watson and Wolf‐Klein, and evaluated for reliability, and predictive accuracy, using receiver operating characteristic (ROC) curve analysis.
Results
The area under the ROC curve was largest for the Shulman (0.79, 95% CI 0.70–0.85) and Mendez (0.78, 95% CI 0.70–0.85) methods. Both predicted dementia more accurately than the Sunderland (area = 0.71) and Watson (area = 0.65) methods (p < 0.05). The inter‐rater (0.81–0.93) and intra‐rater (0.87–0.96) correlation coefficients were high for all five methods.
Conclusions
While substantial differences among the clock scoring methods were evident in our sample, the accuracy of each was modest at best. Unless further studies in relevant settings suggest otherwise, we caution on the use of clock drawing alone to screen for dementia. Copyright © 2001 John Wiley & Sons, Ltd.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>clock drawing</subject><subject>Cognition</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>dementia</subject><subject>Dementia - diagnosis</subject><subject>Dementia - psychology</subject><subject>diagnostic accuracy</subject><subject>Female</subject><subject>gold standard</subject><subject>Humans</subject><subject>Male</subject><subject>Mass Screening - methods</subject><subject>Medical sciences</subject><subject>Neurology</subject><subject>Neuropsychological Tests - standards</subject><subject>Observer Variation</subject><subject>Predictive Value of Tests</subject><subject>Psychometrics</subject><subject>Reproducibility of Results</subject><subject>ROC Curve</subject><subject>ROC curve analysis</subject><subject>Tropical medicine</subject><issn>0885-6230</issn><issn>1099-1166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0F1rFDEUBuAgil2r-A8kIFRFpp4km4-5rIuuQmm1LXgZMpkz27EzkzWZUfffm2WWeiVeHXLy8B54CXnO4JQB8HebbToVkj8gCwZlWTCm1EOyAGNkobiAI_Ikpe8A-Y-Zx-SIMSHEkusF2ZxRH_qti20KAw0NbdqfSH0X_B1NPsR22NAex9tQJzql_evqckVfR_SYYaRhi9GN-72_ddH5EXPS2Po31E8xJ7nBdbvUpqfkUeO6hM8O85jcfPxws_pUnF-uP6_Ozgu_1IoXtRPgGkAmKlMqRFlXuDSurLl3zBstwWhTSa5q4SrwEsGDlBo195WTRhyTkzl2G8OPCdNo-zZ57Do3YJiS1WCYlvr_kDMGSjLI8NUMfQwpRWzsNra9izvLwO67t7l7m7vP8sUhcqp6rP-6Q9kZvDwAl7zrmugG36Z7VyoQXGX1dla_2g53_7pm11-u56PFrHPr-Pteu3hnlRZa2m8Xa_tVvZdXS3Zhr8Ufj_WpQQ</recordid><startdate>200104</startdate><enddate>200104</enddate><creator>Storey, Joella E.</creator><creator>Rowland, Jeffrey T. J.</creator><creator>Basic, David</creator><creator>Conforti, David A.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>200104</creationdate><title>A comparison of five clock scoring methods using ROC (receiver operating characteristic) curve analysis</title><author>Storey, Joella E. ; Rowland, Jeffrey T. J. ; Basic, David ; Conforti, David A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4762-da30af0e13b896ee5dbe48a9d2ca1c8750878b526d3ab0c5e0c0557e72cba583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>clock drawing</topic><topic>Cognition</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>dementia</topic><topic>Dementia - diagnosis</topic><topic>Dementia - psychology</topic><topic>diagnostic accuracy</topic><topic>Female</topic><topic>gold standard</topic><topic>Humans</topic><topic>Male</topic><topic>Mass Screening - methods</topic><topic>Medical sciences</topic><topic>Neurology</topic><topic>Neuropsychological Tests - standards</topic><topic>Observer Variation</topic><topic>Predictive Value of Tests</topic><topic>Psychometrics</topic><topic>Reproducibility of Results</topic><topic>ROC Curve</topic><topic>ROC curve analysis</topic><topic>Tropical medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Storey, Joella E.</creatorcontrib><creatorcontrib>Rowland, Jeffrey T. J.</creatorcontrib><creatorcontrib>Basic, David</creatorcontrib><creatorcontrib>Conforti, David A.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Storey, Joella E.</au><au>Rowland, Jeffrey T. J.</au><au>Basic, David</au><au>Conforti, David A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A comparison of five clock scoring methods using ROC (receiver operating characteristic) curve analysis</atitle><jtitle>International journal of geriatric psychiatry</jtitle><addtitle>Int. J. Geriat. Psychiatry</addtitle><date>2001-04</date><risdate>2001</risdate><volume>16</volume><issue>4</issue><spage>394</spage><epage>399</epage><pages>394-399</pages><issn>0885-6230</issn><eissn>1099-1166</eissn><abstract>Objective
To compare the accuracy of five clock scoring methods for detecting dementia in English‐speaking patients.
Design
A prospective cohort study.
Setting
A general geriatric outpatient clinic in southwest Sydney, Australia.
Participants
A total of 127 consecutive new referrals to the clinic, of mean age 78.2 years.
Measurements
The clock drawing test was conducted at the beginning of each clinic appointment by a blinded observer. Each patient was then assessed by a geriatrician, who collected demographic data, administered the modified Barthel index, the geriatric depression scale, and the Folstein Mini‐Mental State Examination, and categorised each patient as demented or not demented, according to DSM‐4 criteria. Each clock was scored according to the methods of Mendez, Shulman, Sunderland, Watson and Wolf‐Klein, and evaluated for reliability, and predictive accuracy, using receiver operating characteristic (ROC) curve analysis.
Results
The area under the ROC curve was largest for the Shulman (0.79, 95% CI 0.70–0.85) and Mendez (0.78, 95% CI 0.70–0.85) methods. Both predicted dementia more accurately than the Sunderland (area = 0.71) and Watson (area = 0.65) methods (p < 0.05). The inter‐rater (0.81–0.93) and intra‐rater (0.87–0.96) correlation coefficients were high for all five methods.
Conclusions
While substantial differences among the clock scoring methods were evident in our sample, the accuracy of each was modest at best. Unless further studies in relevant settings suggest otherwise, we caution on the use of clock drawing alone to screen for dementia. Copyright © 2001 John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>11333427</pmid><doi>10.1002/gps.352</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Biological and medical sciences clock drawing Cognition Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases dementia Dementia - diagnosis Dementia - psychology diagnostic accuracy Female gold standard Humans Male Mass Screening - methods Medical sciences Neurology Neuropsychological Tests - standards Observer Variation Predictive Value of Tests Psychometrics Reproducibility of Results ROC Curve ROC curve analysis Tropical medicine |
| title | A comparison of five clock scoring methods using ROC (receiver operating characteristic) curve analysis |
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