A Comparison of Five Brief Screening Tools for HIV-Associated Neurocognitive Disorders in the USA and South Africa

被引:61
作者
Joska, J. A. [1 ]
Witten, J. [2 ]
Thomas, K. G. [2 ]
Robertson, C. [1 ]
Casson-Crook, M. [1 ]
Roosa, H. [3 ]
Creighton, J. [3 ]
Lyons, J. [4 ]
McArthur, J. [3 ]
Sacktor, N. C. [3 ]
机构
[1] Groote Schuur Hosp, Dept Psychiat & Mental Hlth, HIV Mental Hlth Res Unit, Anzio Rd, ZA-7925 Cape Town, South Africa
[2] Univ Cape Town, Dept Psychol, ACSENT Lab, Cape Town, South Africa
[3] Johns Hopkins Univ, Sch Med, Baltimore, MD USA
[4] Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA
关键词
HIV-dementia; HIV-associated neurocognitive disorders; Screening; MONTREAL COGNITIVE ASSESSMENT; HEPATITIS-C VIRUS; DEMENTIA SCALE; INFECTED INDIVIDUALS; IMPAIRMENT; HIV/AIDS; VALIDITY; PERFORMANCE; PREVALENCE; UTILITY;
D O I
10.1007/s10461-016-1316-y
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Screening for HIV-associated neurocognitive disorders (HAND) is important to improve clinical outcomes. We compared the diagnostic sensitivity and specificity of the mini-mental state examination, International HIV dementia scale (IHDS), Montreal cognitive assessment, Simioni symptom questionnaire and cognitive assessment tool-rapid version (CAT-rapid) to a gold standard neuropsychological battery. Antiretroviral-experienced participants from Cape Town, South Africa, and Baltimore, USA, were recruited. The sensitivity and specificity of the five tools, as well as those of the combined IHDS and CAT-rapid, were established using 2 x 2 contingency tables and ROC analysis. More than a third (65165) had symptomatic HAND. In detecting HIV-D, the CAT-Rapid had good sensitivity (94 %) and weak specificity (52 %) (cut-point a parts per thousand currency sign10), while the IHDS showed fair sensitivity (68 %) and good specificity (86 %) (cut-point a parts per thousand currency sign10). The combined IHDS and CAT-rapid showed excellent sensitivity and specificity for HIV-D at a cut-off score of a parts per thousand currency sign16 (out of 20; 89 and 82 %). No tool was adequate in screening for any HAND. The combination IHDS and CAT-rapid tool appears to be a good screener for HIV-D but is only fairly sensitive and poorly specific in screening for any HAND. Screening for milder forms of HAND continues to be a clinical challenge.
引用
收藏
页码:1621 / 1631
页数:11
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