title: Use of the clock-drawing test in a hospice population.
abstract: BACKGROUND
  Cognitive impairment is common in patients with advanced disease and has significant implications for the patient, their carers and hospice staff. The effectiveness of screening tools is limited by a number of factors. The clock-drawing test (CDT) has performed well in other settings but has rarely been studied in the hospice setting.
  
  
  OBJECTIVE
  To assess the performance of the CDT in a hospice population.
  
  
  METHODS
  Consecutive admissions to a large hospice over three months were assessed using the CDT, the abbreviated mental test score and brief tests of attention and memory function.
  
  
  RESULTS
  One-hundred and nine eligible patients were admitted and 77% took part. Thirty per cent were cognitively impaired. The CDT had a sensitivity of 0.92, a specificity of 0.73 and a negative predictive value of 0.95. No patient refused to complete it.
  
  
  CONCLUSIONS
  The CDT performs well as a screening tool for cognitive impairment in a hospice population.
authors.affiliation: Department of Psychological Medicine, Institute of Psychiatry, London. m.henderson@iop.kcl.ac.uk
authors.forename: M
authors.initials: M
authors.lastname: Henderson
authors.forename: S
authors.initials: S
authors.lastname: Scott
authors.forename: M
authors.initials: M
authors.lastname: Hotopf
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003221:Confusion / Q000175:diagnosis*; D003704:Dementia / Q000175:diagnosis*; D005260:Female; D017051:Hospice Care; D006801:Humans; D008297:Male; D016743:Mental Competency; D008609:Mental Status Schedule / Q000592:standards*; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*