Frequency Of Low Scores Research Articles

The Frequency of Low Scores on ImPACT in Adolescent Student-Athletes: Stratification by Race and Socioeconomic Status Using Multivariate Base Rates

ABSTRACT This study examined the associations between the frequency of low scores on the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) by race and socioeconomic status (SES), using the proxy of Title I school status, among adolescent student-athletes and calculated multivariate base rates. There were 753 participants assigned to groups based on race (White: n = 430, 59.8%; Black: n = 289, 40.2%) and SES. Black student-athletes obtained more low neurocognitive test scores, which was associated with lower SES. The current study offers a resource to clinicians involved in concussion management who may wish to consider race and SES when interpreting ImPACT test performances.

Knowledge, beliefs and practices regarding prevention of bacterial meningitis in Burkina Faso, 5 years after MenAfriVac mass campaigns.

BackgroundTo adapt communications concerning vaccine prevention, we studied knowledge, beliefs and practices around meningitis risk and prevention in a young adult population in Burkina Faso in 2016, 5 years after the MenAfriVac® mass campaign and one year before the vaccine’s inclusion in the infant immunization schedule.MethodsIn a representative sample of the population aged 15 to 33 years (N = 220) in Bobo-Dioulasso, Burkina Faso, study nurses administered a standardized paper questionnaire consisting of predominantly open questions, collecting information on meningitis risk factors and prevention, and on exposure to dry air and kitchen fire smoke. We identified themes and analyzed their frequency. We created a meningitis knowledge score (range 0 to 4) based on pre-defined best responses and analyzed the determinants of knowledge score levels ≥2 (basic score) and ≥3 (high score) using multivariate logistic regression.ResultsBiomedically supported facts and good practices were known by the majority of participants (eg vaccine prevention, 84.5%). Younger women aged 15–20 years had a higher frequency of low scores <2 (17.0%) compared to older women aged 21–33 years (6.3%) and men of both age groups (3.8%). Junior secondary School attendance explained the differences between the two groups of women, the gender gap for the older, but not the young women, and explained score differences among young women. Local understandings and practices for risk and prevention were commonly reported and used (risk from unripe mango consumption and prevention through nasal application of shea nut butter).DiscussionThis study shows a gender gap in knowledge of meningitis risk and prevention, largely due to education-level inequalities. Women below 21 years had particularly low levels of knowledge and may need interventions outside schools and perinatal care. Our study suggests a strong adherence to local understandings of and practices around meningitis risk and prevention, which should be taken into account by vaccination promotion.

C-33 Abnormal MoCA Scores in a Clinic-Referred Sample

Abstract Objective To examine Montreal Cognitive Assessment (MoCA) performance and frequency of low scores among veterans with primary diagnoses of cognitive disorder, psychiatric disorder, or no disorder. Method A clinic-referred sample of veterans (n = 214; Mage = 66.1, SD = 15; Medu = 13.3, SD = 2.7) diagnosed with mild cognitive impairment (MCI; n = 97), dementia (n = 47), depression (n = 18), PTSD (n = 22), or no cognitive or psychiatric disorder (n = 30) were included. All participants were administered the MoCA as part of a larger battery of tests. Analysis of covariance (ANCOVA), controlling for age and education, was conducted (Bonferroni correction applied) to compare diagnostic groups on MoCA uncorrected total score. Results Across groups, mean MoCA scores were significantly different using ANCOVA, F(4, 207) = 31.5, p &lt; .001. As expected, those with no diagnosis (M = 24.7, SD = 2.1) or psychiatric disorders (PTSD M = 24.4, SD = 4.1; Depression M = 23.9, SD = 3) scored higher than those with cognitive disorder (MCI M = 21.7, SD = 3.1; Dementia M = 17.4, SD = 4.1), p &lt; .001. While both psychiatric groups scored higher than those with dementia (p &lt; .001), the depression group did not significantly differ from those with MCI (p = .11). Examination of scores across all groups revealed a majority of participants scored below the recommended cutoff of &lt; 26. Specifically, 100% of dementia cases, 89.7% of MCI cases, 63.3% of no diagnosis cases, 50% of PTSD cases, and 72.2% of depression cases scored &lt; 26. Conclusion Abnormal MoCA scores are common, even in the absence of cognitive impairment. Individuals with PTSD or depression are likely to score below the publisher's recommend cutoff. While this may reflect cognitive symptoms of psychiatric conditions, it may also reflect normative limitations as identified in past studies.

NIH toolbox cognition tests following traumatic brain injury: Frequency of low scores.

To apply multivariate base rate analyses to the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) to facilitate the identification of cognitive impairment in individuals with traumatic brain injury (TBI). Research Method/Design: In a multisite cross-sectional design, 158 participants who sustained a complicated mild or moderate TBI (n = 74) or severe TBI (n = 84) at least 1 year earlier were administered the NIHTB-CB. The NIHTB-CB is comprised of 2 crystallized cognition tests (reflecting premorbid ability) and 5 fluid cognition tests, measuring processing speed, memory, and executive functioning. Base rates for obtaining 0 to 5 low fluid cognition scores were calculated across a range of cutoffs for defining a low test score (≤25th to 5th percentiles). Base rates of low scores in the TBI sample were compared to the NIHTB-CB normative sample using diagnostic accuracy statistics. The proportion of the TBI sample obtaining low scores decreased as the cutoff for defining a low score decreased. Individuals with lower premorbid cognitive ability, as measured by NIHTB-CB Crystallized Composite score, tended to produce more low scores on the NIHTB-CB fluid cognition tests, even when using fully demographically adjusted scores. Certain patterns of low scores were associated with TBI (defined as likelihood ratio >2.0), whereas others were nonspecific, occurring almost as often in participants without TBI. Premorbid ability stratified base rate tables provided in this article can guide researchers and clinicians in the interpretation of NIHTB-CB performance in adults with TBI. (PsycINFO Database Record

The RAPID-II Neuropsychological Test battery for subjects aged 20 to 49 years: Norms and cognitive profile

IntroductionCognitive evaluation of young subjects is now widely carried out for non-traumatic diseases such as multiple sclerosis, HIV, or sleep disorders. This evaluation requires normative data based on healthy adult samples. However, most clinicians use a set of tests that were normed in an isolated manner from different samples using different cutoff criteria. Thus, the score of an individual may be considered either normal or impaired according to the norms used. It is well established that healthy adults obtained low-test scores when a battery of tests is administered. Thus, the knowledge of low base rates is required so as to minimize false diagnosis of cognitive impairment. The aim of this study was twofold (1) to provide normative data for RAPID-II battery in healthy adults, and (2) estimate the proportion of healthy adults having low scores across this battery. MethodsNorms for the 44 test scores of the RAPID-II test battery were developed using the overall sample of 335 individuals based on three categories of age (20 to 29, 30 to 39, and 40 to 49 years) and two educational levels: Baccalaureate or higher educational degree (high educational level), lower than baccalaureate (low educational level). The 5th, 25th, 50th, and 75th percentiles were calculated from the six age and education subsamples and used to define norms. The frequency of low scores on the RAPID-II battery was calculated by simultaneously examining the performance of 33 primary scores. A low score was defined as less than or equal to the 5th percentile drawn from the six age and education normative subsamples. In addition, the percentages of low scores were also determined when all possible combinations of two-test scores across the RAPID-II were considered in the overall normative sample. ResultsOur data showed that 59.4% subjects of the normative sample obtained at least one or more low score. With more than 9 test scores, this percentage was equal to 0% in the normative sample. Among all combinations of two-test scores, 96% had a false positive rate<2%. ConclusionLow scores are very common in young healthy subjects and are more obvious when simultaneously analyzing test scores across a battery of tests and are thus not necessarily indicative of cognitive impairment. The combinations of two-test scores can be a useful tool to improve the interpretation of low scores.

Poster 40 Comparing Patients With Mild Traumatic Brain Injury to Trauma Controls on CNS Vital Signs

To compare performance on a computerized neuropsychological test battery, CNS Vital Signs (CNS-VS), in a sample of patients with mild traumatic brain injury (MTBI) and trauma controls. Quasi-Experimental, Two-Group, Between-Subjects Design. Participants were 50 patients who met the WHO Collaborating Center Task Force criteria for MTBI and 31 trauma controls. Groups were similar in age, years of education, and estimated intellectual ability. A substantial minority (28%) of the MTBI group had a trauma-related abnormality on day-of-injury CT (i.e., a “complicated MTBI”). Participants were recruited from the Emergency Department of Vancouver General Hospital. The CNS-VS, which generates a Neurocognition Index (NCI) and five primary domain scores, was administered approximately six to eight weeks post injury. Differences in mean performance were examined with a MANOVA and exploratory ANOVAs. Differences in the frequency of low scores at four cutoffs (1SD, <10th percentile, ≤5th percentile, and there was no significant difference between groups for the NCI. A MANOVA using the five domain scores did not reveal statistically significant differences between the groups. Moreover, there were no group differences on any of the domain scores on exploratory ANOVAs. The frequencies of low scores at each cutoff, although more common in the MTBI sample, were not statistically different. At the group level, participants with MTBI did not differ on computerized testing when compared to trauma controls six to eight weeks following injury.