title: Telephone-based cognitive screening for stroke patients in China.
abstract: BACKGROUND
  Valid telephone assessment for cognitive impairment is lacking in stroke settings. We investigated the feasibility and validity of the 5-minute National Institute of Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) protocol and six-item screener (SIS) in stroke patients by telephone administration.
  
  
  METHODS
  Patients were assessed with a comprehensive face-to-face neuropsychological assessment after three months of stroke onset, followed by the 5-minute NINDS-CSN protocol (30 points) and SIS (6 points) at least one month later. Administration time was recorded for the telephone tests. Validity of both tests was determined using the area under the receiver operating characteristics curve (AUC).
  
  
  RESULTS
  Eighty-nine patients (age, 62.9 ± 8.6 years; male, 65.2%) received a face-to-face assessment and 80 completed telephone tests. The time required to administer the 5-minute NINDS-CSN protocol was 4.3 ± 1.0 minutes, and SIS 57.3 ± 17.7 seconds. Validity of detecting cognitive impairment as assessed by AUC was 0.86 (95% CI, 0.78-0.94) for 5-minute NINDS-CSN protocol, and 0.74 (95% CI, 0.63-0.85) for SIS. Sensitivity and specificity were optimal with the cut-off values of 23.5/24 for the 5-minute NINDS-CSN protocol, and 4/5 for SIS.
  
  
  CONCLUSIONS
  Both the telephone-based 5-minute NINDS-CSN protocol and SIS were feasible and valid in screening cognitive impairment after stroke in China.
authors.affiliation: Department of Neurology,Jinling Hospital,Medical School of Nanjing University,Nanjing,China.
authors.forename: Xiangliang
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Neurology,Jinling Hospital,Medical School of Nanjing University,Nanjing,China.
authors.forename: Xinying
authors.initials: X
authors.lastname: Fan
authors.affiliation: Department of Neurology,Jinling Hospital,Medical School of Nanjing University,Nanjing,China.
authors.forename: Lingling
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of Neurology,Jinling Hospital,Medical School of Nanjing University,Nanjing,China.
authors.forename: Lihui
authors.initials: L
authors.lastname: Duan
authors.affiliation: Department of Neurology,Jinling Hospital,Medical School of Nanjing University,Nanjing,China.
authors.forename: Zhaojun
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Neurology,Jinling Hospital,Southern Medical University,Nanjing,China.
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Neurology,Jinling Hospital,Medical School of Nanjing University,Nanjing,China.
authors.forename: Qiliang
authors.initials: Q
authors.lastname: Dai
authors.affiliation: Department of Neurology,Jinling Hospital,Medical School of Nanjing University,Nanjing,China.
authors.forename: Dezhi
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Neurology,Jinling Hospital,Medical School of Nanjing University,Nanjing,China.
authors.forename: Xiaohao
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Neurology,Jinling Hospital,Southern Medical University,Nanjing,China.
authors.forename: Zhonglun
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Neurology,Jinling Hospital,Medical School of Nanjing University,Nanjing,China.
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Xiong
authors.affiliation: Department of Neurology,Jinling Hospital,Medical School of Nanjing University,Nanjing,China.
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
mesh_terms: D000368:Aged; D002681:China; D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012680:Sensitivity and Specificity; D020521:Stroke / Q000523:psychology*; D013689:Telephone
keywords: China; Montreal cognitive assessment; cognitive impairment; neuropsychology; six-item screener; stroke; telephone assessment; validation study