Valid Screening Test Research Articles

Multicenter Validation of the English Version of the Dépistage Cognitif de Québec: a Cognitive Screening Tool for Atypical Dementias.

Early detection of atypical dementia remains difficult partly because of the absence of specific cognitive screening tools. This creates undue delays in diagnosis and management. The Dépistage Cognitif de Québec (DCQ; dcqtest.org) was developed in French and later validated in participants with atypical syndromes. We report the validation of the English version. This multicentre prospective validation study was conducted in 10 centers across Canada and the United States on 260 English-speaking participants aged over 50. We translated and modified the original French DCQ to add targeted stimuli to the Visusopatial Index and social cognition vignettes to the Behavioral Index. A backward translation was performed and equivalence between languages was assessed by administering both tests to 30 bilingual participants. Mean DCQ total score (out of 100) was 95.0 (SD = 3.6). Spearman's correlation coefficient showed a strong and significant correlation (r = 0.49, p < .001) with the Montreal Cognitive Assessment. Test-retest reliability was good (Spearman's coefficient = 0.72, p < .001) and interrater reliability, excellent (intraclass correlation = 0.97, p < .001). Normative data shown in percentiles were stratified by age and education for a population-based sample of 260 English-speaking controls aged between 50 and 87years old. Similar to the French version, the English DCQ proved to be a valid cognitive screening test. The original version was very sensitive to detect atypical dementias such as primary progressive aphasias, Alzheimer's disease' variants and syndromes along the frontotemporolobar degeneration spectrum. This 20-min test can be administered à la carte and offers an alternative to detailed comprehensive neuropsychological evaluations.

Diagnostic accuracy of the Clock Drawing Test in screening for early post-stroke neurocognitive disorder: the Nor-COAST study

BackgroundPost-stroke neurocognitive disorder, though common, is often overlooked by clinicians. Moreover, although the Montreal Cognitive Assessment (MoCA) has proven to be a valid screening test for neurocognitive disorder, even more time saving tests would be preferred. In our study, we aimed to determine the diagnostic accuracy of the Clock Drawing Test (CDT) for post-stroke neurocognitive disorder and the association between the CDT and MoCA.MethodsThis study is part of the Norwegian Cognitive Impairment After Stroke study, a multicentre prospective cohort study following patients admitted with acute stroke. At the three-month follow-up, patients were classified with normal cognition, mild neurocognitive disorder, or major neurocognitive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Any neurocognitive disorder compromised both mild- and major neurocognitive disorder. The CDT at the three-month assessment was given scores ranging from 0 to 5. Patients able to complete the CDT and whose cognitive status could be classified were included in analyses. The CDT diagnostic accuracy for post-stroke neurocognitive disorder was identified using receiver operating characteristic curves, sensitivity, specificity, positive predictive value, and negative predictive value. The association between the MoCA and CDT was analysed with Spearman’s rho.ResultsOf 554 participants, 238 (43.0%) were women. Mean (SD) age was 71.5 (11.8) years, while mean (SD) National Institutes of Health Stroke Scale score was 2.6 (3.7). The area under the receiver operating characteristic curve of the CDT for major neurocognitive disorder and any neurocognitive disorder was 0.73 (95% CI, 0.68–0.79) and 0.68 (95% CI, 0.63–0.72), respectively. A CDT cutoff of < 5 yielded 68% sensitivity and 60% specificity for any neurocognitive disorder and 78% sensitivity and 53% specificity for major neurocognitive disorder. Spearman’s correlation coefficient between scores on the MoCA and CDT was 0.50 (95% CI, 0.44–0.57, p < .001).ConclusionsThe CDT is not accurate enough to diagnose post-stroke neurocognitive disorder but shows acceptable accuracy in identifying major neurocognitive disorder. Performance on the CDT was associated with performance on MoCA; however, the CDT is inferior to MoCA in identifying post-stroke neurocognitive disorder.Trial registrationClinicalTrials.gov (NCT02650531). Retrospectively registered January 8, 2016.

Translation and validation of the audiovisual version of the Montreal cognitive assessment in older adults in Brazil

BackgroundThe use of a reliable remote cognitive screening test for older adults is crucial for the diagnosis of cognitive impairment. This study aimed to translate and validate the audiovisual Montreal Cognitive Assessment (MoCA)for older adults in Brazil.MethodsOne hundred and fourteen older adults were recruited from the community and demographic, functional, mood, and cognitive data were collected. Participants were classified into two groups: cognitively healthy or mild cognitive impairment (MCI). Statistical analyses were performed in order to assess the validity of the test and the cutoff score.ResultsThe psychometric properties of the audiovisual MoCA showed good convergent validity. The audiovisual MoCA was represented as a unifactorial adjusted model, the composite reliability value was acceptable and a cutoff point of ≥23 reached adequate sensitivity and specificity at 0.77 and 0.92, respectively.ConclusionsThe translated audiovisual MoCA is a valid and reliable cognitive screening test that can be administered remotely in older adults in Brazil. The test demonstrated a great ability to discriminate older adults with MCI from cognitively healthy adults. Future studies should focus on validating the audiovisual MoCA using other target population groups in order to expand the use of this remote screening test.

Turkish Validation of the Rapid Interactive Screening Test for Autism in Toddlers.

It is important to diagnose autism spectrum disorder at an early age and to start an early intervention program without delay. In this study, we aimed to validate the Rapid Interactive Screening Test for Autism in Toddlers (RITA-T) in a group of Turkish children and found that the RITA-T which has been shown to be a valid and reliable screening test for 18- to 36-month-old children in studies conducted in different countries, is also valid in Turkish children. Similar to previous studies, our results showed that the RITA-T has good sensitivity and specificity in distinguishing children with autism spectrum disorder. We think that our study will contribute to the timely initiation of early intervention programs for many children with autism by enabling a valid test to be used in screening programs.

Alcohol, Smoking and Substance Involvement Screening Test validity in bipolar and psychotic disorders.

Patients with multi-episode bipolar and psychotic disorders have a high prevalence of substance use disorders, with negative consequences. A brief, easily administered screening test such as the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is needed to identify those at risk in order to intervene appropriately. However, the ASSIST has not yet been validated in this population. This article aims to determine the validity and reliability of the ASSIST in detecting substance use disorders in patients with multi-episode bipolar and psychotic disorders. Western Cape Province, South Africa. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Health Disorders, 4th Edition (DSM-IV) Axis I Disorders (SCID-I) was used as the gold standard for detecting substance abuse and dependence. Cronbach's alpha was used to determine the internal consistency of the ASSIST, and receiver operating characteristic analysis was used to evaluate its screening properties. Optimal cut off scores were calculated to maximise sensitivity and specificity. A total substance involvement lifetime score of ≥13 was found to have optimal sensitivity and specificity of just over 74%. The optimal cutoff score for alcohol was ≥4 and for cannabis, methamphetamine, and 'other drugs' was ≥3. The area under the curve was 0.7 or above for both the total and specific substance involvement scores. The ASSIST is a psychometrically sound screening test for substance use disorders in patients with multi-episode bipolar and psychotic disorders. This is the first study to validate the ASSIST in this population.

A pilot study for a practical screening tool for dementia: validation of 5-minute cognitive test in a geriatric population.

The aim of this study is to validate the Turkish version of the 5-minute cognitive test (FCT) in a geriatric population. In total, 61 participants aged ≥65 years with normal cognitive functions, mild cognitive impairment (MCI), and early stage dementia were included. The FCT was compared to the standardised Mini Mental State Examination (MMSE) and the Qmci-TR (quick mild cognitive impairment) test. Test reliability for the FCT was strong (Cronbach's α = 0.747). We demonstrated a strong correlation of FCT scores with MMSE and Qmci-TR scores (respectively, r = 0.730, P < 0.001, r = 0.723, P < 0.001). The fact that the scores obtained in the dementia group were significantly lower also showed that the test can be used reliably in the differentiation of MCI and early dementia (P < 0.001). The FCT is a brief, reliable, and valid cognitive screening test for screening dementia at early stages in a Turkish geriatric population.

Adult ADHD Positive Screening and Sibship, Birth Order and Academic Achievement: Implications for Epidemiologists and Physicians in the Kingdom of Saudi Arabia.

Attention deficit hyperactivity disorder (ADHD) among the youth and university students differs internationally. This study aims to assess the prevalence of ADHD positivity from a validated screening test among medical students across the Kingdom of Saudi Arabia (KSA) and its associated sociodemographic and family-related factors and the impact of ADHD on students' academic performance. Also, to highlight the implications of the current findings on epidemiologists and family physicians in the region. This cross-sectional study utilised the Adult ADHD Self-Report Scale (ASRS) symptom checklist along with several questions on sociodemographic, siblings and personal academic achievement. Multivariable logistic regression models were performed to obtain the Odds Ratios (ORs) of risk of ADHD screening positivity and their 95% confidence intervals (CIs) against potential predictors. The overall prevalence of positively screened medical students was 38.86%. After adjustment, a statistically significant increased risk of ADHD positivity was observed for students who had one sibling (OR = 1.70, 95% CI = 1.09-2.64). Also, upon examination of birth order, a significant increased risk was observed for students who were firstborn (OR = 1.22, 95% CI = 1.02-1.47). With regard to academic achievement, both before and after adjustment, students who screened positive had a 14% increased risk of obtaining an F GPA (OR = 1.14, 95% CI = 0.99-1.30). A considerable number of medical students are potentially positive for ADHD. Albeit not diagnostically confirmed - this indicates that a substantial number of people have displayed symptoms akin to ADHD, but were not clinically diagnosed. Research into ADHD in the region is still in its infancy, and epidemiologists would benefit from high-quality databases to address this condition. Also, primary care physicians should develop skills in detecting and managing ADHD in children at an earlier age to improve symptoms in adulthood.

Validity and Internal Consistency of the Indonesian-Translated Communication and Symbolic Behavior Scales Developmental Profile to Screen Language Delay in Children Aged 6–24 Months

The Communication and Symbolic Behavior Scales Developmental Profile (CSBS DP) is a valid and reliable screening tool for detecting language delay in children. However, it has not been translated into the Indonesian language. This study aimed to determine the validity and internal consistency of the Indonesian-translated CSBS DP as a screening tool for language delay in children aged 6–24 months. A cross-sectional study was carried out at the Growth and Development Clinic, Cipto Mangunkusumo Hospital, in 3 stages: (1) transcultural translation and adaptation of the measure into the Indonesian language; (2) determination of the internal consistency of the measure; and (3) determination of the concurrent validity of the measure by comparing CSBS DP with the Bayley Scales of Infant and Toddler Development, third edition (BSID-III) language scale on 149 caregivers–children dyads. We found good concurrent validity (r &gt; .3) and good internal consistency with Cronbach's α values of 0.876–0.896. The concurrent validity of the Indonesian-translated questionnaire showed a sensitivity of 71.43% and a specificity of 81.48%. CSBS DP Indonesian-translated questionnaire is a valid and reliable screening test for language delay in children aged 6–24 months.

A comparison of the five-minute cognitive test with the mini-mental state examination in the elderly for cognitive impairment screening.

The five-minute cognitive test (FCT) is a novel cognitive screening method with the quick and reliable merit for detecting cognitive impairment at an early stage. The diagnostic power of FCT in differentiating subjects with cognitive impairment from people with cognition in a normal range was demonstrated effective as that of the Mini-Mental Status Evaluation (MMSE) in a previous cohort study. Here, we analyzed the effect of sociodemographic and health-related factors on FCT performance and further investigated the consistency of FCT. Then, we compared the correlation of subitem scores of FCT or MMSE with a comprehensive battery of neuropsychological tests that focus on specific domains of cognition. Finally, the association of the total FCT scores with the volumes of brain subregions was investigated. There were 360 subjects aged 60 years or above enrolled in this study, including 226 adults with cognitive abilities in normal range, 107 subjects with mild cognitive impairment (MCI) and 27 mild Alzheimer's disease (AD). The results showed that the total FCT scores was negatively associated with increasing age (β = -0.146, p < 0.001), and positively associated with education attainment (β = 0.318, p < 0.001), dwelling condition with family (β = 0.153, p < 0.001) and the Body Mass Index (β = 1.519, p < 0.01). The internal consistency of the FCT (Cronbach's α) was 0.644. The sub-scores of FCT showed a significant correlation with other specific neuropsychological tests. Impressively, the total FCT scores showed a significantly positive association with the volumes of hippocampus related subregions (r = 0.523, p < 0.001) and amygdala (r = 0.479, p < 0.001), but not with cerebellum (r = 0.158, p > 0.05) or subcortical subregions (r = 0.070, p > 0.05). Combining with previous data, FCT is a reliable and valid cognitive screening test for detecting cognitive impairment in a community setting.

Investigating the Psychometric Properties of Sex Addiction Screening Test-revised for Persian Population

Introduction: Sexual addiction is known as a disorder that afflicts a person with difficulty in controlling or delaying sexual behaviors. To prevent social, physical, and psychological consequences, validated screening tests are needed to diagnose this disorder. One of these tests is established by Carnes with the name of sexual addiction screening test-revised (SAST-R). In this study, SAST-R has been translated and verified in the Persian language. Methods: The original screening test was translated into the Persian language and also back-translated for matching by two separate expert teams. The data was collected through an online survey of 1268 participants who were in the age range of 18 to 65 years (Mean±SD 29.44±6.90), and 56.1% and 43.9% of the population were women and men, respectively. Three questionnaires, including the SAST-R, the hypersexual behavior consequences scale, and the Connor-Davidson resilience scale as the principal, convergent, and divergent tests were administered to the participants. Results: The reliability of the test’s internal consistency (Cronbach α=0.883), split-half (Cronbach α=0.779), and Guttman (lambda coefficients were between 0.773 to 0.883) tests were used. In addition, 4 methods of content validity (sexual hyperactivity specialist approved), convergent structure validity (P&lt;0.001, R=0.731), the validity of divergent structure (P&lt;0.09, R=-0.132), and factor validity (comparative fit index=0.884, goodness of fit index=0.873, root mean square error of approximation=0.047) were measured and confirmed the validity of the test. Conclusion: The Persian version of SAST-R is a reliable preclinical tool to assess the severity of sexual desire in patients.

Metagenomic next‑generation sequencing of BALF for the clinical diagnosis of severe community‑acquired pneumonia in immunocompromised patients: A single‑center study.

The diagnostic methods of conventional microbiological tests (CMTs) for severe community-acquired pneumonia (SCAP) may be too complicated or impossible to use in polymicrobial infections, and it may be difficult to identify unexpected pathogens. CMTs are also limited due to the early application of broad-spectrum or prophylactic antimicrobial drugs and the fastidious or slow-growing pathogenic microorganisms. The present study aimed to investigate the value of mNGS compared with CMTs in the clinical diagnosis of SCAP in immunocompromised individuals. Therefore, 37 patients diagnosed with SCAP in immunocompromised adult patients were enrolled from the Respiratory Intensive Care Unit of the First Affiliated Hospital of Soochow University (Soochow, China) between May 1, 2019, and March 30, 2022. A bronchoalveolar lavage fluid sample from each individual was divided in half. Half was sent to the microbiology laboratory directly for examination, and the other one was sent for DNA extraction and sequencing. In addition, other relevant specimens (such as blood) were sent for CMTs, including culture or smear, T-spot, acid-fast stain, antigen detection, multiplex PCR and direct microscopic examination. Based on a composite reference standard, the diagnostic outcomes were compared between CMTs and mNGS. Among the enrolled patients, 31 patients were diagnosed with microbiologically confirmed pneumonia, with 16 (43.2%) having monomicrobial infections, while 15 (40.5%) had polymicrobial infections. Fungi were the most common etiologic pathogens in immunosuppressive individuals. Pneumocystis jirovecii (45.9%) and Aspergillus spp. (18.9%) were the most common etiologic pathogens. Initial screening test validity of mNGS [sensitivity=96.8%; specificity=33.3%; positive predictive value (PPV)=88.2%; negative predictive value (NPV)=66.6%; likelihood ratio (LR)+, 1.45; LR-, 0.10) was higher compared with that of CMTs (sensitivity=38.7%; specificity=82.3; PPV=92.3%; NPV=20.8%; LR+, 2.3; LR-, 0.74). The total diagnostic accuracy of mNGS was superior to CMTs and it was statistically significantly different [86.5% (32/37) vs. 45.9% (17/37); P<0.001]. In conclusion, the total diagnostic accuracy of mNGS was superior to CMTs for SCAP in immunocompromised patients as an important diagnostic method.

An Assessment of the Validity and Reliability of the Social-Media Addiction Screening Scale (S-MASS)

Objective: The excessive use of social media can lead to addiction among many vulnerable individuals. Hence, the utilization of a valid and reliable screening test to assess social media addiction is warranted. Materials and Methods: The Social-Media Addiction Screening Scale (S-MASS) is a newly developed, self-report screening scale containing 16 items that assess the three main components of behavioral addiction: giving priority, impaired control, and negative consequences. The S-MASS reliability was measured using Cronbachs alpha. An exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were employed to assess the S-MASS factorial validity. A latent profile analysis (LPA) was also carried out to identify the classes of problematic social media users. Results: In all, 5,068 participants aged 13 years were recruited from five high schools and an online survey. Cronbachs alpha for the S-MASS was 0.90 (95% CI: 0.890.90), indicating excellent test reliability. The EFA and CFA revealed a good factorial validity for the S-MASS. Based on the LPA, the participants were classed as “lowrisk” (n = 1,227; 24.2%), “moderate-risk” (n = 2,757; 54.4%), and “high-risk” (n = 1,084; 21.4%) problematic social media users. The key differences between these classes were gender, age, necessity to use social media for work, self-perception of addiction, and time spent on social media. Conclusion: The S-MASS is a valid and reliable screening scale for social media addiction. The criterion validity of the S-MASS should be evaluated once formal diagnostic criteria for social media addiction become available.

Development of a Group Emergent Literacy Screening Tool

It is important to identify children who are struggling with emergent literacy skills as early as possible to provide them with the support they need to prevent future academic failure. Screening tools administered in groups are more cost-effective than those administered individually, but few are available in Portugal. The goal of this study was to explore the psychometric properties (difficulty, reliability, and validity) of a group emergent literacy screening test for Portuguese-speaking children. The test includes two phonological awareness tasks, one vocabulary task, and one concepts of print task. The sample comprised 1379 children from pre-K (n = 314), kindergarten (n = 579), and first grade of primary education (n = 486). Measures of emergent literacy, reading and writing skills, and academic achievement were used to test the validity of the screening test. The Rasch model results suggest that the tasks were suitably difficult for the kindergarten group, but had varying levels of difficulty for pre-K and first grade. Reliability was adequate for the tasks with an appropriate level of difficulty. Scores for the screening test were highly correlated with measures of literacy and with academic achievement. These findings suggest that the presented emergent literacy screening test is valid and reliable, making it a useful tool for practice and research.

Evaluating a Novel, Portable, Self-Administrable Device ("Beacon") That Measures Critical Flicker Frequency as a Test for Hepatic Encephalopathy.

We compared critical flicker frequency (CFF) thresholds obtained using a novel portable device "Beacon" with thresholds from the commercially available Lafayette Flicker Fusion System (Lafayette-FFS) in patients with cirrhosis. One hundred fifty-three participants with chronic liver disease underwent CFF testing using Beacon and Lafayette-FFS with a method-of-limits and/or forced-choice protocol. Beacon demonstrated excellent test-retest reliability (intraclass correlation 0.91-0.97) and good correlation with the Lafayette-FFS values (intraclass correlation 0.77-0.84). Forced-choice CFF were on average 4.1 Hz higher than method-of-limits descending CFFs. Beacon can be self-administered by patients with chronic liver disease and cirrhosis to measure CFF, a validated screening test for minimal hepatic encephalopathy.

The validity and reliability of the Arabic translation of the Pediatric Sleep Questionnaire

Objective/backgroundObstructive sleep apnea (OSA) is a common sleep disorder in childhood. Polysomnography is the gold standard for the diagnosis of OSA. However, it is expensive and time-consuming, and it may be unavailable. The self-administered Pediatric Sleep Questionnaire (PSQ) is a reliable and validated screening test featuring high sensitivity (0.85) and specificity (0.87). It has been translated into multiple languages and is widely used to screen for OSA in children. This study translated the PSQ into Saudi Arabian Arabic and validated it. Patients/methodsThe Arabic-PSQ was translated using forward-backward translation, following established guidelines. A review committee monitored the process and approved the final version. The reliability of the scale was measured using Cronbach's alpha and kappa statistics. The validity of the Arabic-PSQ was evaluated using confirmatory factor analysis (CFA). ResultsOur study recruited 220 Saudi children with potential adenoid hypertrophy from King Abdulaziz University hospital clinics. The Arabic-PSQ had excellent internal consistency (Cronbach's α 0.946). Additionally, all subscales had excellent reliability, with Cronbach's α of 0.924 for snoring, 0.762 for sleepiness, and 0.820 for behavior. Test-retest reliability showed excellent agreement of >80% in all items (p < 0.0001). CFA for the Arabic-PSQ confirmed a significant correlation between the items of each subscale. ConclusionsThe Arabic-PSQ is reliable, validated, and culturally adapted. It can be safely used to screen for OSA in children. However, given this study's limitations, the diagnostic efficacy of the Arabic-PSQ should be assessed in future studies.

1339 IMPROVING INPATIENT MANAGEMENT OF DELIRIUM IN A DISTRICT GENERAL HOSPITAL

Abstract Background Delirium is a common clinical condition associated with increased morbidity and mortality, and prolonged hospital stay. Early detection is vital to improving management of the condition and improving outcomes. Aims Improve delirium detection using the 4AT screening tool as a validated approach; Improve delirium management across multiple domains using the PINCH ME approach; documented attempt at collateral history within 24 hours of recognition of delirium; obtain serological confusion screen in patients with recognised delirium. (100% each) Method Plan Do Study Act (PDSA) method was used to conduct this Quality Improvement (QI) project over 12 months. Data was obtained from paper and electronic records in the medical wards with regards to 'at risk patients' (i.e. over 65y, acutely unwell, background of cognitive impairment and/or acute fracture). The use of 4AT or alternative delirium screens from the emergency department (ED) and medical teams were noted. Assessment for pain, urinalysis, serological screens, bowel and nutrition review including MUST scores, medication reviews were looked for. Interventions included presentation and education at the medicine grand round, publishing a poster, and a PINCHME alert sticker for the medical notes to use at time of assessment. 2 PDSA cycles were completed and post sticker results obtained. Results Baseline data shows that collateral history was attempted for 70% patients - improved to 100% after sticker use. Use of validated screening test from 15% to 100% after sticker use. Nutrition assessment improved from 15% to 40%. Serological testing improved from 40% to 53%. 100% patients received a medication review after sticker use. Conclusion Introduction of PINCHME sticker serves as a prompt to ensure holistic management. Currently delirium management is clinician dependent as there is lack of formal delirium management pathway. Further plan includes involving nursing staff and 'delirium champions' to bring about a formal pathway for lasting change.

DIAGNOSTIC ACCURACY OF ALLENS TEST FOR ULNAR COLLATERAL FLOW IN RADIAL ARTERY HARVESTING IN CORONARY ARTERY BYPASS GRATING

To treat coronary artery disease, coronary artery bypass graft (CABG) surgery is done worldwide (CAD). Before harvesting the radial artery for cardiac bypass surgery, Allen's test is frequently used to evaluate the hand's ulnar collateral blood supply. Using Doppler Ultrasonography as a gold standard, this study was created to evaluate the diagnostic precision of Allen's test for the ulnar collateral flow of the donor limb before radial arteryharvesting. This cross-sectional study was conducted from January 2015 to September 2017 at the Jinnah Hospital in Lahore's Cardiac Surgery department. The consecutive sampling/non-probability method was employed. A signed consent form was obtained, and specific demographic data (name, age, and gender) was gathered. SPSS version 21 was used to enter and analyze all of the data. The patients in our study had a mean age of 50.91±9.13 years. The ratio of men to women was 1.3:1. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of Allen’s test was 77.05%, 81.36%, 81.03%, 77.42% &amp; 79.17% taking Doppler test as gold standard. Allen's test, which uses Doppler ultrasonography as the gold standard, is a reliable and valid screening test for the ulnar collateral flow of the donor limb before radial artery harvesting, according to the findings of our study.

Applicability of Sniffin' Sticks Identification Test as a Screening Tool for Olfactory Dysfunction in Northeast China.

BACKGROUND Because most case of smell loss are unrecognized, a valid and reliable screening test for olfactory function is needed. The Sniffin' Sticks test is one of the most widely used olfactory tests. As olfaction can be affected by environment and social background, we investigated the regional applicability of Sniffin' Sticks identification subtest as a screening tool. MATERIAL AND METHODS Normosmic volunteers were recruited between May 2021 and August 2021. We collected data on participants' age, sex, and educational level. The Self-Reported Mini-Olfactory Questionnaire and identification test of Sniffin' Sticks test battery were used to assess their olfactory function. RESULTS A total of 688 subjects (316 male, 371 female) volunteered for the screening test. The mean age of participants was 30±7.69 years (range, 15-63 years), and the average score of all subjects was 12.7±0.81 points. The 3 least recognized items among all 16 tests were lemon (correct identification rate 5.4%), clove (correct identification rate 1.5%), and apple (correct identification rate 0.7%). For Self-Reported Mini-Olfactory Questionnaire, 48 of the 687 subjects (7%) stated that they could not recognize the smell of freshly mowed grass. CONCLUSIONS We investigated the applicability of using Sniffin' Sticks Identification test and Self-MOQ as a screening tool for olfactory dysfunction in northeast China. Most of the subjects enrolled in this study failed to reach the normative standard for their age groups in the Sniffin' Sticks test. We suggest the deletion or replacement of items with extremely low correct identification rates and that physicians who use the Sniffin's Sticks test in clinical practice test the applicability in advance to avoid misdiagnosis.

Comparison of the Telephone‐Montreal Cognitive Assessment (T‐MoCA) and Telephone Interview for Cognitive Status (TICS) as Remote Screening Tests for Early Alzheimer’s Disease.

AbstractBackgroundThe number of Americans with Alzheimer’s disease (AD) is expected to rise to nearly 14 million by 2060. This alarming number shows a critical need for brief mental status tests that can be administered remotely (e.g., by telephone or videoconferencing) to large numbers of individuals while maintaining the ability to reliably detect cognitive impairment related to AD. Therefore, we sought to validate a recently developed, remotely administered cognitive screening measure, the T‐MoCA, against an established remote measure, the TICS, and prior in‐person clinical and cognitive assessment that provided clinical diagnosis. Relationships with CSF biomarkers of AD were also examined.MethodsThe TICS and T‐MoCA were completed approximately one‐week apart by 215 participants at the UCSD ADRC. Test order was partially counterbalanced. Extensive in‐person clinical and neuropsychological assessment had been completed on average 1.5 years prior and participants classified as cognitively normal (CN; n = 167), mild cognitive impairment (MCI; n = 25) or dementia (n = 23). CSF had been obtained from 79 participants within 48 months of remote testing and levels of Aβ 1–40 and 1–42, phosphorylated tau (p‐tau), and total tau were measured.ResultsTICS and T‐MoCA scores were highly correlated overall (r = .787;p&lt;.001), and moderately within specific MCI (r = .657;p&lt;.001) and dementia (r = .673,p = .001) groups (r = .309, p&lt;.001 for CN only). Groups differed significantly on TICS (F(2,212) = 156.66;p&lt;.001) and T‐MoCA (F(2,210) = 143.72;p&lt;.001), with dementia&lt;MCI&lt;NC on both (p’s&lt;.001). TICS and T‐MoCA had excellent ability to discriminate CN from cognitively impaired (i.e., MCI/dementia) with ROC areas under the curve of .889 and .902, respectively. Optimal cut‐off scores were &lt;17/22 for T‐MoCA (90.4% sensitivity, 76.6% specificity) and &lt;34/41 for TICS (91.0% sensitivity, 74.5% specificity). A composite CSF biomarker of AD (total tau/Aβ 1–42 ratio) was negatively correlated with TICS (r = ‐.372;p = .001) and T‐MoCA (r = ‐.480;p&lt;.001).ConclusionThe T‐MoCA and TICS are valid brief cognitive screening tests with remote administration that can distinguish individuals with cognitive impairment from those who are cognitively normal. The two tests have similar discriminative ability and degree of association with levels of AD biomarkers in CSF. Thus, the T‐MoCA and TICS are promising measures to meet the growing need for remote cognitive screening for AD.

Digital pair-matching of iliac bones: pilot study on a three-dimensional approach with models acquired through stereophotogrammetry

Three-dimensional (3D) pair-matching has brought about an innovative approach for the analysis of commingled skeletal remains, and it has been tested on bone models acquired through CT and laser scans. Here, 3D models of 40 innominate bones (20 left and 20 right) of 20 documented male individuals from a cemeterial skeletal collection were acquired through a stereophotogrammetric device (VECTRA M3, Canfield Scientific, Inc.). The ventral iliac surface was chosen as the anatomical region of interest (ROI) for the analysis. Each left ROI was mirrored and superimposed on the matching right ROI (contralateral element from the same individual) and mismatching ROIs (contralateral elements from different individuals). The point-to-point distance between models was calculated through the Vectra Analysis Module (VAM) software and the root mean square (RMS) point-to-point distance value was used to evaluate the sorting performance of the method, in terms of sensitivity and specificity rates. Differences in RMS between matches and mismatches were investigated through a Student’s t test (p < 0.05). The state of preservation of the remains was assessed following an index of anatomical completeness and differences in RMS distances of true matches according to different anatomical completeness were assessed through the Mann–Whitney test (p < 0.05). RMS point-to-point distances of matches and mismatches were significantly different (p < 0.01), being the matches lower than mismatches. The RMS threshold of 2.9 mm identified all the true pairs; the test was 100% sensitive and 51% specific. The RMS of matches with a better state of preservation are significantly lower than the less preserved matches (p < 0.05). In general, a low RMS distance value may indicate a true match, being it to be further verified. The 3D approach for sorting innominate bones provides a valid screening test that could complete subjective and osteometric methods with numerical evidence of the match. Preliminary data suggest a possible relation between RMS distance values and taphonomic condition, which would benefit from further research.