| Publication Abstract Display | | Type: Published Manuscript | | Title: A screening algorithm to identify clinically significant changes in neuropsychological functions in the Diabetes Control and Complications Trial. | | Authors: Lan S, Ryan CM, Adams KM, Grant I, Heaton RK, Rand LL, Jacobson AM, Nathan DM, Cleary PA, and the DCCT Research Group | | Year: 1994 | | Publication: Journal of Clinical and Experimental Neuropsychology : official journal of the International Neuropsychological Society | | Volume: 16 Issue: Pages: 303-316 | | Abstract:Neuropsychological (NP) evaluations provide an accepted means of monitoring safety in multi-center long-term medical trials. However, using neuropsychologists to review test protocols and rate level of clinical impairment can be a costly and logistically complex undertaking. To facilitate that process, the DCCT Research Group developed a computerized screening strategy that utilized statistical models to identify individuals with possible cognitive deterioration. Two hundred and eight subjects with insulin-dependent diabetes mellitus were assessed twice, 2 years apart, with an extensive battery of NP tests, and the results were rated by expert clinicians. Multiple logistic regression was used to develop a statistical model to predict clinically significant NP worsening (as determined by clinical raters) on the basis of changes in scores (year 2--baseline) derived from the actual tests. A subsequent performance evaluation with an additional 1087 subjects demonstrated that the computerized algorithm was highly successful in identifying individuals with significantly worsened NP performance. Despite a high false positive rate, the algorithm can achieve an 80-90% reduction in the number of cases requiring evaluation by expert neuropsychologists. |
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