Details

Autor(en) / Beteiligte

• Can, Serdar Suleyman
• Kizil, Erguvan Tugba Ozel
• Varli, Murat
• Turan, Engin
• Atli, Teslime

Titel

Psychometric properties of the Turkish versions of three different clock drawing tests in patients with dementia/Demans hastalarinda uc farkli saat cizme testinin Turkce uyarlamalarinin psikometrik ozellikleri

Ist Teil von

• Noro-Psikiyatri Arsivi, 2010-06, p.91

Ort / Verlag

AVES

Erscheinungsjahr

2010

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Objective: Clock Drawing Test (CDT) has been widely used in dementia screening as a practical and valid tool assessing various neuropsychological domains. Many scoring systems requiring different instructions and methodologies were proposed for CDT and there are several studies comparing the diagnostic accuracy of these methods. However, there is still no clear agreement on which one is the best for clinical and research settings. The present study aimed to investigate the psychometric properties of the Turkish versions of the three most commonly used CDTs (Shulman's, Sunderland's and Watson's CDTs) and to compare their diagnostic accuracy with each other and Mini Mental State Examination (MMSE). Methods: The study sample consisted of elderly patients with dementia (n=65) and healthy controls (n=112) who were admitted to the Department of Geriatric Psychiatry and Geriatrics of a University hospital. The subjects were administered MMSE and CDT. In CDTs, the subjects were asked to place the numbers and the hands of a clock in a pre- drawn circle showing the time setting for the clock as "10 after 11". CDTs were scored according to three different CDT scoring methods (Shulman, Sunderland and Watson) by two blinded raters. Discriminant and concurrent validity and interrater reliability were assessed. Receiver operating characteristic (ROC) analysis was also performed to calculate cut-off scores and sensitivity/specificity values. Areas under the curve (AUCs) of CDTs were compared. Results: The mean scores of all CDTs were significantly different in dementia patients compared to the controls. CDT scores were significantly correlated with MMSE scores. All CDTs had high sensitivity values, while Watson's CDT had lower specificity. AUC value for MMSE was higher than that for CDTs and AUC value for Watson's CDT was lower than the values for the other two CDTs. When Shulman/Sunderland CDTs were used together with MMSE, the sensitivity increased up to 100%. Conclusion: The Turkish versions of all three CDTs can be used in dementia screening. Shulman's or Sunderland's CDT may be preferred to Watson's CDT, since they have higher specificity and diagnostic accuracy. Key words: Clock drawing, dementia, validity, reliability Amac: Saat Cizme Testi (SCT) bircok noropsikolojik bileseni degerlendiren ve demans taramasinda yaygin olarak kullanilan pratik bir aractir. SCT icin bircok farkli uygulama ve puanlama yontemi onerilmistir. Ancak, henuz tek bir yontem uzerinde gorus birligine varilamamistir. Bu calismada, en sik kullanilan uc SCT'nin (Shulman, Sunderland ve Watson) Turkce uyarlamalarinin psikometrik ozelliklerinin arastirilmasi ve demans tanisini yordama gucleri bakimindan birbirleri ve Standardize Mini Mental Test (SMMT) ile karsilastirilmasi amaclanmistir. Yontemler: Calismaya bir universite hastanesinin Geropsikiyatri poliklinigine basvuran ve demans tanisi alan yasli hastalar (n=65) ile Geriatri poliklinigine basvuran ve demansi olmayan yaslilar (n=112) alinmistir. Katilimcilara SMMT ve SCT uygulanmistir. SCT'de daire uzerine saatin rakamlari ve kollarini saat 10 geceyi gosterecek bicimde cizmeleri istenmistir. SCT'ler taniya kor iki degerlendirici tarafindan Shulman, Sunderland ve Watson SCT puanlama yonergelerine gore puanlanmistir. SCT'lerin ayirdedici gecerligi, aynilik gecerligi, degerlendiriciler arasi guvenirligi degerlendirilmistir. Ayrica ROC analizi ile kesme puanlari, duyarlik ve ozgulluk degerleri hesaplanmis, ROC egrileri altinda kalan alanlar karsilastirilmistir. Bulgular: Demans ve kontrol grubu arasinda SCT puanlari acisindan anlamli fark bulunmustur. SCT ile SMMT puanlari arasinda anlamli korrelasyon saptanmistir. Uc SCT'nin de demans tanisinda duyarliliklarinin yuksek oldugu, Watson SCT'nin ozgullugunun dusuk oldugu gorulmustur. SMMT icin ROC egrisi altinda kalan alanin SCT'lere gore daha fazla, Watson SCT icin ise egri altinda kalan alanin diger SCT'lere gore daha dusuk oldugu saptanmistir. SMMT ile Shulman/Sunder-land SCT'ler beraber kullanildiginda duyarliligin %100'e ciktigi bulunmustur. Sonuc: Her uc SCT'nin Turkce versiyonlari demans riskini belirlemede tarama araci olarak kullanilabilir. Shulman veya Sunderland yontemleri ozgullukleri ve yordama gucleri daha fazla oldugundan, Watson SCT'ye tercih edilebilir. Anahtar kelimeler: Saat cizme, demans, gecerlik, guvenirlik