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Accuracy of Telephone-Based Cognitive Screening Tests: Systematic Review and Meta-Analysis

[ Vol. 17 , Issue. 5 ]

Author(s):

Emma Elliott, Claire Green, David J. Llewellyn and Terence J. Quinn*   Pages 460 - 471 ( 12 )

Abstract:


Background: Telephone-based cognitive assessments may be preferable to in-person testing in terms of test burden, economic and opportunity cost.

Objective: We sought to determine the accuracy of telephone-based screening for the identification of dementia or Mild Cognitive Impairment (MCI).

Methods: Five multidisciplinary databases were searched. Two researchers independently screened articles and extracted data. Eligible studies compared any multi-domain telephone-based assessment of cognition to the face-to-face diagnostic evaluation. Where data allowed, we pooled test accuracy metrics using the bivariate approach.

Results: From 11,732 titles, 34 papers were included, describing 15 different tests. There was variation in test scoring and quality of included studies. Pooled analyses of accuracy for dementia: Telephone Interview for Cognitive Status (TICS) (<31/41) sensitivity: 0.92, specificity: 0.66 (6 studies); TICSmodified (<28/50) sensitivity: 0.91, specificity: 0.91 (3 studies). For MCI: TICS-modified (<33/50) sensitivity: 0.82, specificity: 0.87 (3 studies); Telephone-Montreal Cognitive Assessment (<18/22) sensitivity: 0.98, specificity: 0.69 (2 studies).

Conclusion: There is limited diagnostic accuracy evidence for the many telephonic cognitive screens that exist. The TICS and TICS-m have the greatest supporting evidence; their test accuracy profiles make them suitable as initial cognitive screens where face to face assessment is not possible.

Keywords:

Cognitive Impairment, dementia, telephone assessment, sensitivity, specificity, cognitive screening, diagnostic accuracy.

Affiliation:

Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, University of Exeter Medical School, Exeter, Devon, U.K.; 3The Alan Turing Institute, London, NW1 2DB, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow



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