A Systematic Review of the Diagnostic Accuracy of Automated Tests for Cognitive Impairment

International Journal of Geriatric Psychiatry

Aslam, R. W., Bates, V., et al. (2018).

International Journal of Geriatric Psychiatry, 33(4), 561-575.

This systematic review investigates the diagnostic accuracy of automated computerized tests of cognition for diagnosing or monitoring individuals with mild cognitive impairment (MCI) or early dementia.

Health Technology Assessment Programme

January 2005 to August 2015

Diagnostic studies

16

Sixteen studies investigated the diagnostic accuracy of 11 different automated computerized tests of cognition for diagnosing or monitoring individuals with MCI or early dementia. For the nine index tests used to diagnose MCI, the following psychometric characteristics were reported: <ul> <li>The Cambridge Neuropsychological Test Automated Battery (CANTAB) had sensitivity of 79.7% and specificity of 76.3%.</li> <li>The Computer Assessment of Mild Cognitive Impairment (CAMCI) had sensitivity ranging from 80% to 86% and specificity ranging from 74% to 94%.</li> <li>The Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment (CANS-MCI) had sensitivity of 89% and specificity of 73%.</li> <li>The CogState had sensitivity ranging from 76% to 78% and specificity ranging from 79% to 90% across domains.</li> <li>The CogniScreen had sensitivity ranging from 76% to 92.6% and specificity ranging from 60% to 80% across domains.</li> <li>The CogState Brief Battery (CBB) had sensitivity ranging from 41.1% to 80.4% and specificity ranging from 84.7% to 85.7% across domains.</li> <li>The Placing Test (TPT) computerized total (novel and traditional) had sensitivity of 70% and specificity of 76.2%.</li> <li>Mindstreams computerized cognitive testing and an unnamed computerized test had no reported sensitivity or specificity.</li> </ul> For the three index tests used to diagnose either MCI or early dementia, the following psychometric characteristics were reported: <ul> <li>The Cambridge Neuropsychological Test Automated Battery Paired Associated Learning (CANTAB-PAL) had sensitivity of 96.9% and specificity of 80.8%.</li> <li>The Computerized Self-Test (CST) had sensitivity of 80% and specificity of 87%.</li> <li>Mindstreams (abridged) had no reported sensitivity or specificity.</li> </ul> Due to the limited research available, the authors were unable to draw conclusions about the diagnostic accuracy of automated computerized tests of cognition for diagnosing MCI in individuals. Additional research on these index tests is warranted.