洛文斯顿作业疗法认知评定量表中文运用软件的灵敏度与特异度

Sensitivity and Specificity of Chinese Software of Loewenstein Occupational Therapy Cognitive Assessment

目的探讨洛文斯顿作业疗法认知评定量表(LOTCA)中文运用软件的灵敏度与特异度,并与简明智能状态检查表(MMSE)比较。方法以急性颅脑损伤、脑卒中、脑出血患者为研究对象,63例完成MMSE检查,其中32例同时完成LOTCA中文运用软件的评定,同时由3位专家各自对患者是否存在认知障碍进行独立评定,差额投票法判定专家的综合意见。以专家评定为金标准,比较LOTCA、MMSE的灵敏度、特异度、Kappa系数、Youden指数,分析LOTCA与MMSE的相关性。结果各专家对患者认知状况的评估无统计学差异;MMSE与LOTCA的灵敏度(特异度)分别为95.1%(83.3%),31.8%(71.4%)、LOTCA的Kappa系数及Youden指数均高于MMSE两倍以上;MMSE与LOTCA计分相关性显著(r=0.743,P=0.00)。结论LOTCA中文运用软件的诊断价值高,在精确评定与认知科研中选用LOTCA优于MMSE。

Objective To evaluate the sensitivity and specificity of Chinese software of Loewenste.in occupational therapy cognitive assessment （LOTCA） and to compare with mini-mental state examination （MMSE）. Methods Patients with brain injury including traumatic brain injury, stroke and intracerebral hemorrhage were assessed through MMSE （63 cases） and Chinese Software of LOTCA （32 cases）. Three experts on cognition rehabilitation independently evaluated whether the patients had cognitive disability, and their comprehensive conclusion were drawn through differential voting. Taking experts conclusion as golden standard, sensitivity, specificity, Kappa coefficient and Youden index of LOTCA were calculated and compared with MMSE. Results No statistical differences were found of MMSE and LOTCA between different experts. The sensitivity （specificity） of LOTCA and MMSE were 95. 1 % （83.3 %） and 31.8% （71.4%）, and Kappa coefficient and Youden index of LOTCA were more than two times of those in MMSE. Scores of LOTCA eorrela ted with those in MMSE significantly （r = 0. 743, P = 0. 00）. Conclusion Chinese software of LOTCA demonstrated bet ter efficiency on evaluating cognition disorder than MMSE, especially in the fields of cognition study and intensive assess merit.