![]() The scores from each section are added up to get the total MoCA score, which ranges from 0 to 30. Shared Decision Making and Communicationĭear Drs Tsoi, Chan, Hirai, Wong, and Kwok, A recently published meta-analysis of the effectiveness of different cognitive screens in detecting dementia stated that the Mini-Cog and the ACE-R are the best alternative screening tests to the MMSE due to their high pooled sensitivity and specificity compared to other alternative screens.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Ĭlinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. The MoCA test is scored by assigning points to different sections and tasks within the test. However the data are at odds with this conclusion. The Mini-Cog is reported to have pooled sensitivity and specificity values of 0.91 (0.80-0.96) and 0.86 (0.74-0.93), respectively. However, the reported values for the GPCOG are numerically higher with respective values of 0.92 (0.81-0.97) and 0.87 (0.83-0.90). Still, there is no true zero point, meaning that a score of zero doesn’t indicate a complete absence of intelligence. oncerning the individual screening strategies, many clinical tests to evaluate the driving aptitude of patients, including cognitive, mental, motor and vision tests, have been proposed. And if you’ve landed here, you’re probably a little confused or uncertain about them. The scores are on an interval scale, where the difference between scores can be quantitatively determined. Levels Of Measurement: Explained Simply (With Examples) If you’re new to the world of quantitative data analysis and statistics, you’ve most likely run into the four horsemen of levels of measurement: nominal, ordinal, interval and ratio. In addition, while the confidence intervals are equally wide between the tests for sensitivity, for specificity they are narrower for the GPCOG than the Mini-Cog. In psychology, interval scales are often used to develop and score IQ tests. In contrast to these reported measures, in the Methods the authors state that a diagnostic odds ratio (DOR) was used as a single indicator of test performance, to account for the trade-off between sensitivity and specificity in the context of different thresholds used across studies. While we agree with this approach, this measure was not reported in the Abstract, Results or online Supplementary Material, so it is unclear to the reader how or if the DOR was actually used to support their conclusions independently of pooled sensitivity and specificity. Taking reported pooled sensitivity (Se) and specificity (Sp) alone, where DOR = (Se x Sp)/((1 – Se) x (1 – Sp)) the GPCOG (76.96) performs better than the Mini-Cog (62.11). Furthermore, the reported prevalence of dementia in the Mini-Cog studies (1182/4178 28.3%) was slightly higher than that of the GPCOG (292/1082 27.0%). Since a higher level of dementia prevalence positively biases the chances of detecting dementia, accounting for prevalence may have further increased the sensitivity and specificity of the GPCOG relative to the Mini-Cog. ![]()
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