Comparison of Scoring Criteria for Clock Drawing Test

Abstract

This study compared clock drawings by 42 medically hospitalized patients with a mean age of 51.9 (SD = 10.1) years, using four sets of published scoring criteria to determine comparability of classification and to assess validity by comparison to other measures of cognitive functioning. We found impairment in 20 of 42 cases using the criteria of Mendez et al. (1992); 11 of 42 cases by Sunderland et al. (1989); 9 of 42 cases with Freedman et al. (1994); and 8 of 42 cases according to Rouleau et al. (1992). Kappa coefficients of impairment status between sets of scoring criteria ranged from .41 to .86. Pearson correlations of raw scores between schemes ranged from .72 to .94. All except Sunderland et al. were significantly correlated with the Standardized Mini-Mental State Examination. All correlated significantly with the Wechsler Adult Intelligence Scale–Revised Block Design; however, only Mendez et al. correlated significantly with the Neurobehavioral Cognitive Status Examination. On the basis of these results and our experience, we recommend using the Freedman scoring scheme.