brief cognitive assessment based on consensus standards in the us and abroad
DESCRIPTION
Brief Cognitive Assessment based on Consensus Standards in the US and Abroad. Dawn Langdon PhD. MS care providers needs. Most interested in receiving consultation on cognition (31.0%) Most interested in CME relating to cognition (40.1%) Highest preference for live conference. - PowerPoint PPT PresentationTRANSCRIPT
Brief Cognitive Assessment based on Consensus Standards in the US and Abroad
Dawn Langdon PhD
MS care providers needs
• Most interested in receiving consultation on cognition (31.0%)
• Most interested in CME relating to cognition (40.1%)
• Highest preference for live conference
Turner et al., JRRD 2006;43:25-34
MS patients’ information needs
• All those questions recommended information about cognition in MS for all patients
• And on average to be given earlier than they had received it
Heesen et al., Acta Neurol Scand 2006;114:268-272
Assessment of Cognition
Comprehensive Batteries
Intermediate length Batteries
Brief Batteries
Screening testsMSNQ
BRBSEFCI
MACFIMS
Ad hoc
Routine in the office
Routine NP exam.
Differential diagnosisDisability questionsRehabilitation programs
4
Cognitive assessment for MS
• Requires specialist training• Time-consuming• Not routinely available outside specialist
centres• Not comparable across countries
BICAMSBrief International Cognitive Assessment for MS
• Identify a brief assessment tool for cognition in MS– can be used by health care professionals who are not
cognitive specialists– has international validation
• Specify an international validation protocol that can be implemented in any country
• Agree guidelines on test-retest timing and clinically significant change
6
BICAMS committee meetings and website are sponsored by Bayer Healthcare
BICAMS committee meetings and website are sponsored by Bayer Healthcare
BICAMSBrief International Cognitive Assessment for MS• Identify a brief assessment tool for cognition in MS• 80 key scientific articles identified• Each article rated by two committee members
– Psychometric standards• Reliability• Validity• Sensitivity
– Pragmatic standards• International applicability• Ease of administration• Feasibility in the specified context• Acceptability to patients
8
BICAMS committee meetings and website are sponsored by Bayer Healthcare
BICAMSBrief International Cognitive Assessment for MS
• No materials required beyond papers, pencil and stopwatch
BICAMS committee meetings and website are sponsored by Bayer Healthcare
Benedict et al. Clin Neuropsychol 2002; 16: 381-97
11
Neuropsychological EvaluationsCalifornia Verbal Learning Test-II (CVLT II)
Truck SpinachGiraffe
BookcaseOnion
MotorcycleCabinetZebraCoachLampCeleryCowDeskBoat
SquirrelCabbage
Benedict et al. Clin Neuropsychol 2002; 16: 381-97
Brief Visuospatial Memory Test (Revised)
RHB Benedict (Clin Neuropsych 1994; Psychol Assess 1996; Psychol Assess Resources 1997).
Benedict et al. Clin Neuropsychol 2002; 16: 381-97 12
BICAMSBrief International Cognitive Assessment for MS
Battery:SDMT
CVLT-II, first recall trialsBVMTR, first recall trials
13BICAMS committee meetings and website are sponsored by Bayer Healthcare
MS patients compared to healthy controls on BICAMS Parmenter et al., JINS 2010;16:6-16
MS (n=395)Mean SD
Controls(n=100)Mean SD P value d’
Age 46.28 8.99 44.79 9.43 ns 0.16
Education 14.28 2.34 14.47 1.72 ns 0.09
BDI-FS 3.39 3.40 0.90 1.40 <.001 0.96
SDMT 49.53 13.20 61.40 9.31 <.001 1.04CVLT-II TL 48.80 10.56 55.79 9.35 <.001 0.70BVMTR TL 20.92 7.17 26.68 5.56 <.001 0.90
Scaled score SDMT CVLT-II (learning trials) BVMTR (learning trials)2 <133 <43 <32 134 43-35 32-35 14-155 46 36-43 166 47-50 44-46 17-197 51-54 47-48 20-228 55-56 49-51 23-249 57-59 52-53 25-2610 60-63 54-57 27-2811 64-66 58-60 29-3012 67-69 61-63 3113 70-72 64-66 3214 73-74 67-70 3315 75-78 71-73 34-3516 79 7417 80-8718 >87 >74 36
BICAMS committee meetings and website are sponsored by Bayer Healthcare
BICAMSBrief International Cognitive Assessment for MS
• Identify a brief assessment tool for cognition in MS– can be used by health care professionals who are not
cognitive specialists– has international validation
• Specify an international validation protocol that can be implemented in any country
17
BICAMS committee meetings and website are sponsored by Bayer Healthcare
BICAMSBrief International Cognitive Assessment for MS
international validation protocol
• Step 1, Standardization and Translation of Test Stimuli.
• Step 2, Standardization and Translation of Test Instructions
• Step 3, Normalization• Step 4, Test-Retest Reliability • Step 5, Criterion-Related Validity
Benedict et al., BMC Neurology (submitted)BICAMS committee meetings and website are sponsored by Bayer Healthcare
BICAMSBrief International Cognitive Assessment for MS:National Validations
Country NC n MS n Data collection started
Data collection completed
Analysis started
Analysis completed
Publi-cation
BICAMS support
Argentina TBD TBD Pending Pending Pending Pending Pending RHB Benedict
Czech Repub
92 130 Mar 2010 Ongoing Pending Pending Pending RHB Benedict
Iran 158 90 Mar 2010 Sep 2011 Oct 2011 Nov 2011 Submitted RHB Benedict
Argentina TBD TBD Pending Pending Pending Pending Pending RHB Benedict
UK 60 60 Pending Pending Pending Pending Pending DW Langdon
Egypt TBD TBD Pending Pending Pending Pending Pending D W Langdon
Estonia TBD TBD Pending Pending Pending Pending Pending DW Langdon
Italy TBD TBD Pending Pending Pending Pending Pending MPAmato
19
BICAMSBrief International Cognitive Assessment for MS
• Identify a brief assessment tool for cognition in MS– can be used by health care professionals who are not
cognitive specialists– has international validation
• Specify an international validation protocol that can be implemented in any country
• Agree guidelines on test-retest timing and clinically significant change
20
BICAMS committee meetings and website are sponsored by Bayer Healthcare
Assessment of Cognition
Comprehensive Batteries
Intermediate length Batteries
Brief Batteries
Screening testsScreening tests
Brief Batteries
Routine in the office
Routine NP exam
Differential diagnosisDisability questionsRehabilitation programs
21
BICAMSRoutine in the clinic
0 mins
15 mins
45 mins
90 mins
120 mins