Validation and interpretation of the Dutch version of the Multiple Sclerosis Neuropsychological Screening Questionnaire.
BACKGROUND
The Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ) was developed for screening of MS patients at risk for cognitive impairment with a patient self-report (MSNQ-P) and an informant version (MSNQ-I). The objective of this study was to validate the Dutch versions and determine their interpretability.


METHODS
The MSNQ was completed by 121 MS patients and their partners (informants). We investigated the factor structure, internal consistency and construct validity. Interrater reliability between MNSQ-P and MSNQ-I was investigated with the intraclass correlation coefficient (ICC) and Cohen's kappa. For interpretability of both MSNQ versions we calculated sensitivity, specificity and cut-off scores. Receiver operating characteristic (ROC) curves with related area under the curve (AUC) were used to evaluate the added value of combining both versions.


RESULTS
We found a unidimensional factor structure. Cronbach's alphas were 0.93 and 0.94 for MSNQ-P and MSNQ-I, respectively. The ICC was 0.59 and kappas were ≤0.50. No cut-off score could be defined for the MSNQ-P because of low sensitivity. For the MSNQ-I, sensitivity was 0.75 and specificity 0.71 (AUC 0.80). The cut-off score was 21. ROC curve analyses showed no added value of the MSNQ-P when used in combination with the MSNQ-I.


CONCLUSIONS
The MSNQ-I is preferred over the MSNQ-P to screen MS patients for cognitive impairment.
Department of Epidemiology and Biostatistics, VU University Medical Center Amsterdam, The Netherlands. judith.sonder@vumc.nl
Judith M
JM
Sonder
Lidwine B
LB
Mokkink
Femke A H
FA
van der Linden
Chris H
CH
Polman
Bernard M J
BM
Uitdehaag
D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000523:psychology*; D009426:Netherlands; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D015588:Observer Variation; D011237:Predictive Value of Tests; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D057566:Self Report; D012680:Sensitivity and Specificity; D018454:Spouses / Q000523:psychology; D014175:Translating