Résumé
Objective:To explore the performance characteristics of the digital clock-drawing test(dCDT) for amnestic mild cognitive impairment(aMCI), and its diagnostic value for aMCI patients compared with the traditional clock-drawing test (tCDT).Methods:Total 81 middle-aged and elderly outpatients in Affiliated Hospital to Shanxi Medical University from November 2020 to May 2021 were selected, including 42 cognitively normal people (control group) and 39 aMCI patients (aMCI group). The dCDT developed by our team was used to collect drawing process parameters (such as stroke length, time and speed). The Cognitive Domain Indexs of Montreal Cognitive Assessment (MoCA) were calculated using the CDIS scoring method, and the correlation between dCDT parameters and MoCA indexs were analyzed.Logistic regression analysis was used to construct the predictive model, and the sensitivity and specificity of different methods for the diagnosis of aMCI patients were compared by the area under the ROC curve.Results:(1) The total time(51.25(38.80, 63.75)s vs 42.42(33.64, 51.91)s) and time in air(36.34(26.81, 47.25)s vs 28.47(22.37, 33.98)s) of the aMCI group were significantly higher than those of the control group, and the minute hand/hour hand ratio(1.23±0.35 vs 1.39±0.34), strokes per minute((31.31±10.44) vs (41.05±9.48))and tCDT score(3.0(3.0, 4.0), 4.0(3.0, 4.0))were significantly lower than those of the control group, and the differences were statistically significant (all P<0.05). Other dCDT parameters were not statistically significant between the two groups ( Z=-1.835--0.440, P>0.05). (2) Correlation analysis showed that the total time was negatively correlated with MoCA MIS( r=-0.224, P=0.049), LIS( r=-0.237, P=0.037)and AIS( r=-0.236, P=0.038); time in air was negatively correlated with MoCA MIS( r=-0.268, P=0.018), LIS( r=-0.271, P=0.016), AIS( r=-0.259, P=0.022)and OISA( r=-0.267, P=0.018); the minute hand/hour hand ratio was positively correlated with MoCA EIS( r=0.259, P=0.022)and VIS( r=0.309, P=0.006); the strokes per minute was positively correlated with MoCA MIS( r=0.376, P=0.001), EIS( r=0.290, P=0.010), VIS( r=0.294, P=0.009), AIS( r=0.238, P=0.036)and OISA( r=0.301, P=0.007). (3)dCDT model composed of the pre-second hand latency, the ratio of minute hand/hour hand, and the strokes per minute can correctly classify 77.8% of aMCI, with a sensitivity of 74.36% and a specificity of 80.95%.Its diagnostic power for aMCI was significantly higher than the tCDT scoring( Z=2.335, P=0.02). Conclusion:The cognitive impairment in aMCI can be detected by dCDT, and different dCDT parameters can reflect the impairment of different cognitive domains.Compared with tCDT scoring, dCDT can improve the diagnostic efficacy of aMCI patients.
Résumé
Objective To comprehensively evaluate the effects of indirect hemagglutination test(IHA),enzyme?linked im?munosorbent assay(ELISA),and dipstick dye method(DDIA)in the diagnosis of schistosomiasis japonica at different preva?lence by using Meta?analysis. Methods Through the literature review according to the inclusion and exclusion criteria,a data?base was established,and by using Meta?disc and R software,the Meta?analysis was performed including the threshold test,het?erogeneity test,weighted by the quantitative effect of merger,SROC curve fitting,etc. Results A total of 60 papers were in?cluded in the final analysis. The sensitivities of IHA were 0.84,0.76 and 0.94 in heavy,medium and low endemic areas,and specificities were 0.73,0.64 and 0.73 respectively;the sensitivities of ELISA were 0.88,0.80 and 0.93 in heavy,medium and low endemic areas,and the specificities were 0.59,0.59 and 0.62 respectively;the sensitivities of DDIA were 0.93,0.81 and 0.93 in the heavy,medium and low endemic areas,and specificities were 0.66,0.69 and 0.59 respectively. The weighted sensi?tivities of IHA,ELISA and DDIA were 0.83,0.87 and 0.90 respectively;the weighted specificities were 0.69,0.60 and 0.62 re?spectively. The areas under the curve of SROC were 0.89,0.96 and 0.92 in IHA,ELISA and DDIA respectively. Conclusions In different prevalence,the effectiveness of different methods for serological diagnosis of schistosomiasis is different. The sensi?tivity and specificity of all diagnostic methods of schistosomiasis need to further improve.