Publication Abstract Display
Type: Published Manuscript
Title: Evaluation of brief screening tools for neurocognitive impairment in HIV/AIDS: A systematic review of the literature.
Authors: Zipursky AR, Gogolishvili D, Rueda S, Brunetta J, Carvalhal A, McCombe JA, Gill MJ, Rachlis A, Rosenes R, Arbess G, Marcotte T, Rourke SB
Year: 2013
Publication: AIDS (London, England)
Volume: 27 Issue: 15 Pages: 2385-2401
Abstract:OBJECTIVE(S):: To systematically review literature on brief screening tools used to detect and differentiate between normal cognition and neurocognitive impairment and HIV-associated neurocognitive disorders (HAND) in adult populations of persons with HIV. DESIGN:: Formal systematic review. METHODS:: We searched six electronic databases in 2011 and contacted experts to identify relevant studies published through May 2012. We selected empirical studies that focused on evaluating brief screening tools (<20 minutes) for neurocognitive impairment in persons with HIV. Two reviewers independently reviewed retrieved literature for potential relevance and methodological quality. Meta-analyses were completed on screening tools that had sufficient data. RESULTS:: Fifty-one studies met inclusion criteria; we focused on 31 papers that compared brief screening tools to reference tests. Within these 31 studies, 39 tools were evaluated and 67% used a comprehensive neuropsychological battery as reference. The majority of these studies evaluated HIV-Associated Dementia (HAD). Meta-analyses demonstrated that the HIV Dementia Scale (HDS) has poor pooled sensitivity (0.48) and the International HIV Dementia Scale (IHDS) has moderate pooled sensitivity (0.62) in detecting a range of cognitive impairment. Five newer screening tools had relatively good sensitivities (>0.70); however, none of the tools differentiated HAND conditions well enough to suggest broader use. There were significant methodological shortcomings noted in most studies. CONCLUSIONS:: HDS and IHDS perform well to screen for HAD but poorly for milder HAND conditions. Further investigation, with improved methodology, is required to understand the utility of newer screening tools for HAND; further tools may need to be developed for milder HAND conditions.

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