Background
Methods
Design
Setting
Study population
Inclusion criteria
Procedure
Statistical analysis
PC study | 43.5€ | |
---|---|---|
Cost of PC physician consultation | 43.5€ | |
CBNU study
|
390.8€
| |
Professionals (neurologist+neuropsychologist+nurse) | 197.4€ | |
Additional test (analysis+cranial CT scan) | 193.4€ | |
Costs per diagnoses
| ||
True Negative (PC study) |
43.5€
| |
True Positive (PC study + CBNU study) |
434.4€
| |
False Positive (PC study + CBNU study) |
434.4€
| |
False Negative ([PC study × 2] + CBNU study) |
477.9€
|
Formal aspects
Results
Sample characteristics
Total | CI | NoCI | CInD | DEM | NoDEM | |
---|---|---|---|---|---|---|
N° Subjects
| 140 | 85 | 55 | 37 | 48 | 92 |
N° females
| 101 (72.1) | 60 (70.6) | 41 (74.5) | 23 (62.2) | 37 (77.1) | 64 (69.6) |
Age in yrs*
| 72.5 ± 11.3 | 77.3 ± 7.6 | 64.9 ± 12.1 | 74.1 ± 7.3 | 79.6 ± 7.0 | 68.6 ± 11.3 |
≤ 50 yrs | 7 (5.0) | 0 (0) | 7 (12.7%) | 0 (0) | 0 (0) | 7 (7.6) |
51-75 yrs | 70 (50.0) | 33 (37.5) | 37 (67.3) | 19 (51.4) | 14 (27.5) | 56 (60.9) |
≥ 76 yrs | 63 (45.0) | 52 (61.2) | 11 (20.0) | 18 (48.6) | 34 (70.8) | 29 (31.2) |
Educational Level
#
| ||||||
Illiterates | 20 (14.3) | 19 (22.4) | 1 (1.8) | 3 (8.1) | 16 (33.3) | 4 (4.3) |
Incomplete primary | 52 (37.1) | 35 (41.2) | 17 (30.9) | 16 (43.2) | 19 (39.6) | 33 (35.9) |
Primary or more | 68 (48.6) | 31 (36.5) | 37 (67.3) | 18 (48.6) | 13 (27.1) | 55 (59.8) |
Years of Education
#
| ||||||
≤8 yrs | 72 (51.4) | 54 (63.5) | 18 (32.7) | 19 (51.4) | 35 (72.9) | 37 (40.2) |
9-17 yrs | 61 (43.6) | 31 (36.5) | 30 (54.5) | 18 (48.6) | 13 (21.3) | 48 (52.2) |
≥ 18 yrs | 7 (5.0) | 0 (0) | 7 (12.7) | 0 (0) | 0 (0) | 7 (7.6) |
MMSE
#
| 19.9 ± 5.7 | 17.2 ± 5.3 | 24.1 ± 3.1 | 21.8 ± 3.5 | 13.8 ± 3.6 | 23.2 ± 3.4 |
MMSEc
@
| 20.8 ± 5.2 | 18.5 ± 5.1 | 24.4 ± 2.9 | 22.8 ± 3.2 | 15.2 ± 3.7 | 23.7 ± 3.1 |
MIS
#
| 4.3 ± 2.9 [117] | 2.6 ± 2.6 [64] | 6.2 ± 1.8 [53] | 4.1 ± 2.5 [34] | 1.0 ± 1.5 [30] | 5.4 ± 2.3 [87] |
Phototest
#
| 29.0 ± 7.6 | 25.4 ± 6.8 | 34.6 ± 5.1 | 30.5 ± 4.8 | 21.5 ± 5.5 | 32.9 ± 5.4 |
Effectiveness and cost for DEM
Test | CoP | Sn | Sp | DA | k | Total Cost (€) | Cost/CD (€) | Mean cost (€) |
---|---|---|---|---|---|---|---|---|
MMSE
|
24/25
| 1.00 (0.93-1.00) | 0.38 (0.28-0.49) | 0.59 (0.46-0.73) | 0.30 (0.16-0.44) | 47134.5 | 585.2 | 336.7 ± 169.9 |
MMSEc
|
24/25
| 1.00 (0.93-1.00) | 0.37 (0.27-0.48) | 0.58 (0.46-0.72) | 0.29 (0.15-0.43) | 47525.4 | 570.6 | 339.5 ± 168.2 |
MMSE
|
*
| 0.96 (0.86-0.99) | 0.62 (0.51-0.72) | 0.74 (0.60-0.89) | 0.50 (0.36-0.64) | 38621.7 | 377.9 | 275.9 ± 193.3 |
MIS#
|
3/4
| 0.93 (0.78-0.99) | 0.80 (0.71-0.88) | 0.83 (0.67-1.00) | 0.63 (0.48-0.78) | 23548.6 | 242.5 | 201.3 ± 193.4 |
MIS#
|
4/5
| 0.96 (0.78-1.00) | 0.71 (0.61-0.80) | 0.78 (0.73-1.00) | 0.54 (0.38-0.69) | 26632.5 | 295.6 | 227.6 ± 196.4 |
Phototest
|
26/27
| 0.81 (0.67-0.91) | 0.89 (0.81-0.95) | 0.86 (0.72-1.00) | 0.70 (0.57-0.83) | 29153.7 | 242.1 | 208.2 ± 196.8 |
DEM | NoDEM | |||||
---|---|---|---|---|---|---|
Test | Phototest ≤26 | Phototest ≥27 | Total | Phototest ≤26 | Phototest ≥27 | Total |
MMSE* +
|
38
| 8 | 46 | 4 | 31 | 35 |
MMSE* -
|
1
| 1 | 2 | 6 | 51 | 57 |
Total
|
39
| 9 | 48 | 10 | 82 | 92 |
χ
2
= 4; p < 0.05 | χ
2
= 15.6, p < 0.001 | |||||
MIS ≤3#
|
21
| 7 | 28 | 5 | 12 | 17 |
MIS ≥4#
|
2
| 0 | 2 | 5 | 65 | 70 |
Total#
|
23
| 7 | 30 | 10 | 77 | 87 |
χ
2
= 1.78; n.s. | χ
2
= 2.11; n.s. |
Effectiveness and cost in CI
Test | CoP | Sn | Sp | DA | k | Total Cost (€) | Cost/CD | Mean cost (€) |
---|---|---|---|---|---|---|---|---|
MMSE
|
26/27
| 0.96 (0.90-0.99) | 0.24 (0.13-0.37) | 0.69 (0.55-0.84) | 0.24 (0.06-0.43) | 55821.3 | 577.9 | 398.7 ± 114.2 |
MMSEc
|
26/27
| 0.96 (0.90-0.99) | 0.27 (0.16-0.41) | 0.69 (0.56-0.84) | 0.27 (0.09-0.45) | 55582.8 | 575.4 | 393.4 ± 121.8 |
MIS#
|
4/5
| 0.73 (0.61-0.84) | 0.87 (0.75-0.94) | 0.79 (0.64-0.97) | 0.59 (0.45-0.74) | 33582.9 | 363.3 | 287.0 ± 197.4 |
Phototest
|
28/29
| 0.69 (0.58-0.79) | 0.93 (0.82-0.98) | 0.78 (0.64-0.95) | 0.58 (0.45-0.74) | 42014.0 | 379.8 | 300.1 ± 195.6 |
CI | NoCI | |||||
---|---|---|---|---|---|---|
Test | Phototest≤28 | Phototest≥29 | Total | Phototest≤28 | Phototest≥29 | Total |
MMSEc ≤26
| 58 | 24 | 82 | 4 | 36 | 40 |
MMSEc ≥27
| 1 | 2 | 3 | 0 | 15 | 15 |
Total
| 59 | 26 | 85 | 4 | 51 | 55 |
χ2 = 19.36; p < 0.001 | χ2 = 32.11; p < 0.001 | |||||
MIS ≤4#
| 38 | 9 | 47 | 0 | 7 | 7 |
MIS ≥5#
| 4 | 13 | 17 | 4 | 42 | 46 |
Total#
| 42 | 22 | 64 | 4 | 49 | 53 |
χ2 = 1.23; ns | χ2 = 0.31; ns |