title: Scoring clock tests for dementia screening: a comparison of two scoring methods.
abstract: OBJECTIVE
  To compare the dementia screening performance of two scoring systems of the clock drawing test.
  
  
  METHODS
  A sample of 1199 elderly subjects was administered the clock drawing test as part of a study on aging and dementia. The clock drawings were scored using published criteria for the two scoring systems that were compared. Additionally, a selection of 103 drawings was scored by three different raters to evaluate inter-rater agreement within each of the two methods. For a selection of 473 drawings the final diagnosis on the presence or absence of dementia was known. For these drawings accuracy for the detection of dementia was compared between the two methods.
  
  
  RESULTS
  The four-item scoring system (Kappa 0.76; sensitivity 0.97; specificity 0.32; PPV 0.53; NPV 0.93) was found to be a little more reliable and as accurate as the six-item scoring system (Kappa 0.67; sensitivity 0.96; specificity 0.42; PPV 0.56; NPV 0.94).
  
  
  CONCLUSIONS
  Since both scoring systems showed largely similar results, primary care physicians and other health care providers should be encouraged to use the four-item scoring checklist as it is easier and requires less time than the more elaborate checklist of the six-item system.
authors.affiliation: Qualidem, Department of General Practice, Catholic University of Leuven, Leuven, Belgium. marjoke.vanderburg@med.kuleuven.ac.be
authors.forename: Marjoke
authors.initials: M
authors.lastname: van der Burg
authors.forename: Anne
authors.initials: A
authors.lastname: Bouwen
authors.forename: Johan
authors.initials: J
authors.lastname: Stessens
authors.forename: Michel
authors.initials: M
authors.lastname: Ylieff
authors.forename: Ovide
authors.initials: O
authors.lastname: Fontaine
authors.forename: Jan
authors.initials: J
authors.lastname: de Lepeleire
authors.forename: Frank
authors.initials: F
authors.lastname: Buntinx
mesh_terms: D000368:Aged; D003071:Cognition; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008403:Mass Screening; D015588:Observer Variation; D011237:Predictive Value of Tests; D011581:Psychological Tests