Age-Specific Cutoff Scores on a T1-Weighted Axial Medial Temporal-Lobe Atrophy Visual Rating Scale in Alzheimer's Disease Using Clinical Research Center for Dementia of South Korea Data

BACKGROUND AND PURPOSE: Visual assessment of medial temporal-lobe atrophy (MTA) has been quick, reliable, and easy to apply in routine clinical practice. However, one of the limitations in visual assessments of MTA is the lack of widely accepted age-adjusted norms and cutoff scores for MTA for a diagnosis of Alzheimer's disease (AD). This study aimed to determine the optimal cutoff score on a T1-weighted axial MTA Visual Rating Scale (VRS) for differentiating patients with AD from cognitively normal elderly people. METHODS: The 3,430 recruited subjects comprising 1,427 with no cognitive impairment (NC) and 2003 AD patients were divided into age ranges of 50–59, 60–69, 70–79, and 80–89 years. Of these, 446 participants (218 in the NC group and 228 in the AD group) were chosen by random sampling for inclusion in this study. Each decade age group included 57 individuals, with the exception of 47 subjects being included in the 80- to 89-year NC group. The scores on the T1-weighted axial MTA VRS were graded by two neurologists. The cutoff values were evaluated from the area under the receiver operating characteristic curve. RESULTS: The optimal axial MTA VRS cutoff score from discriminating AD from NC increased with age: it was ≥as ≥1, ≥2, and ≥3 in subjects aged 50–59, 60–69, 70–79, and 80–89 years, respectively (all p < 0.001). CONCLUSIONS: These results show that the optimal cutoff score on the axial MTA VRS for diagnosing of AD differed according to the decade age group. This information could be of practical usefulness in the clinical setting.

A research on the methods of establishing both domestic and foreign standards of physician qualification examination / 中华医学教育探索杂志

Since the examination of doctor's qualifications came into effect, methods that are set by standard to judge whether one passes the examination or not were in dispute all the while. This article is going to introduce four kinds of methods (Angoff method、Modified Angoff method、Nedelsky method、Borderline group method) which are commonly used at home and abroad. Summarizing their advantages, disadvantages and the usage in the process of standards setting in various countries, we aim to provide reference for setting cutoff score of the examination of doctor's qualifications in China.

The Usefulness of the Korean Version of Penn State Worry Questionnaire for Screening Generalized Anxiety Disorder: A Receiver Operating Characteristic Analysis

OBJECTIVE: Excessive worry about minor matters and a state in which this worry is experienced as uncontrollable are known to be key symptoms of generalized anxiety disorder (GAD). Given the importance of pathological worry in GAD, the need for psychometrically sound measures of this construct has increased. The purpose of this study was to investigate the usefulness of the Korean version of Penn State Worry Questionnaire (K-PSWQ) for screening GAD. METHODS: Two hundred and forty six patients were initially screened, from which 102 GAD patients and 118 patients with anxiety disorder not otherwise specified (anxiety disorder NOS) were finally enrolled. Patients were diagnosed by a structured clinical interview for the DSM-IV Axis I. We also enrolled 114 control subjects who had no medical or psychiatric history. Pathological worry in both patients and control subjects were assessed at baseline using the PSWQ and we estimated optimal cutoff score by the receiver operating characteristic (ROC) analysis. RESULTS: We found that in the first ROC analysis, a score of 53 could simultaneously optimize sensitivity and specificity in order to discriminate GAD patients from control subjects. From the second receiver operating characteristic analysis, when both sensitivity and specificity were optimized, we can suggest a score of 61 as being the cutoff for differentiating GAD patients from patients with anxiety disorder NOS. CONCLUSION: The Korean version of PSWQ is a useful method for screening GAD patients, although ethnic and cultural differences may affect the cutoff score of PSWQ for GAD.

A Study of the Validity of and Cut-Off Scores for the Korean Version of Asperger Syndrome Diagnostic Scale

OBJECTIVES: This study examined the reliability and validity of the Korean version of Asperger Syndrome Diagnostic Scale (K-ASDS), to calculate the cut-off score in the diagnosis of Asperger syndrome. Further, we examined classification error rate when applying cut-off scores. METHODS: One hundred sixty-seven children participated in this study, including 46 with Asperger syndrome, 26 with PDD or PDD NOS, 43 with ADHD, and 52 normal children. RESULTS: An ANCOVA demonstrated no significant differences in the K-ASDS total score between the Asperger and the PDD & PDD NOS groups. However, these groups did show significantly higher scores than the ADHD and normal groups. Among the five subscales on the K-ASDS, the Asperger group obtained significantly higher scores on the language and cognition subscales than the PDD & PDD NOS groups. Two scales were found to be useful in distinguishing the Asperger group from the PDD & PDD NOS group through a discriminant analysis. According to an analysis of ROC curve, the cut-off score on the K-ASDS for the diagnosis of PDD including Asperger syndrome was 121. CONCLUSION: We discussed that K-ASDS has pretty limit.

The application of Angoff method in setting a standard cutoff score for comprehensive Written Test of China National Medical Licensing Examination / 中华医学教育探索杂志

This paper gives a brief introduction to China National Medical Licen sing Examination(NMLE)and focuses on the definition,modification and application protocol of Angoff Method in setting a standard for NMLE Comprehensive Written Test.Statistic analysis indicates the validity of modifled Angoff Method.Suggestion is provided for future improvement.