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FC02-05 - Towards Combining Precision and Brevity: A Prospective Study of Adaptive Cognitive Testing

Published online by Cambridge University Press:  17 April 2020

H. Wouters ,
J. Van Campen ,
B. Appels ,
W.A. Van Gool ,
B. Schmand ,
A.H. Zwinderman  and
R. Lindeboom
H. Wouters
Affiliation:
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands
J. Van Campen
Affiliation:
Department of Geriatric Medicine, Slotervaart Hospital, Amsterdam, The Netherlands
B. Appels
Affiliation:
Department of Medical Psychology, Slotervaart Hospital, Amsterdam, The Netherlands
W.A. Van Gool
Affiliation:
Department of Neurology, Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands
B. Schmand
Affiliation:
Department of Neurology, Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands
A.H. Zwinderman
Affiliation:
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands
R. Lindeboom
Affiliation:
Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands

Abstract

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Objectives

To examine whether cognitive testing can be tailored to individual patients by selecting only items of appropriate difficulty from a large and precise neuropsychological battery. The advantage is a combination of measurement precision with the brevity (of shorter tests).

Methods

39 patients with cognitive complaints and 8 partners who visited a geriatric day care clinic were randomly assigned to administration of the CAMCOG or an extended CAMCOG i.e. with ADAS-cog and neuropsychological tests. Item difficulties were estimated and their validity examined with Rasch analysis. Tailored testing was achieved by Computerised Adaptive Testing (CAT). CAT repeatedly selected an easier item after an incorrect response and a more difficult item after a correct response to estimate the total score. CAT finished the item selection after reaching sufficient reliability (standard error < 0.15).

Results

For test reductions by CAT ranging from 25 to 15 items, intraclass correlations between the CAT estimated total score and actual total score (CAT administered plus remaining items) ranged from .99 to .98 for the CAMCOG and from 0.98 to 0.91 for the extended CAMCOG. Testing time reduction ranged from 42-55% for the CAMCOG (M testing time CAMCOG 39.6 minutes, M testing times CAT 22.9 to 17.8 minutes) and from 45-68% for the extended CAMCOG (M testing time extended CAMCOG 111.3 minutes, M testing times CAT 61-35 minutes).

Conclusions

Substantial test reductions and excellent agreement with the whole battery supports the use of tailored cognitive testing to economically administer batteries that are time consuming in their entire form.

Type
Free Communications
Information
European Psychiatry , Volume 25 , Issue S1: 18th European Congress of Psychiatry. February 27, March 2, 2010 - Munich, Germany , 2010 , 25-E185
Copyright
Copyright © European Psychiatric Association 2010
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