Title:Accuracy of Telephone-Based Cognitive Screening Tests: Systematic Review and Meta-Analysis
VOLUME: 17 ISSUE: 5
Author(s):Emma Elliott, Claire Green, David J. Llewellyn and Terence J. Quinn*
Affiliation:Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ, University of Exeter Medical School, Exeter, Devon, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8QQ
Keywords:Cognitive Impairment, dementia, telephone assessment, sensitivity, specificity, cognitive screening, diagnostic accuracy.
Abstract:
Background: Telephone-based cognitive assessments may be preferable to in-person testing
in terms of test burden, economic and opportunity cost.
Objective: We sought to determine the accuracy of telephone-based screening for the identification of
dementia or Mild Cognitive Impairment (MCI).
Methods: Five multidisciplinary databases were searched. Two researchers independently screened articles
and extracted data. Eligible studies compared any multi-domain telephone-based assessment of
cognition to the face-to-face diagnostic evaluation. Where data allowed, we pooled test accuracy metrics
using the bivariate approach.
Results: From 11,732 titles, 34 papers were included, describing 15 different tests. There was variation
in test scoring and quality of included studies. Pooled analyses of accuracy for dementia: Telephone Interview
for Cognitive Status (TICS) (<31/41) sensitivity: 0.92, specificity: 0.66 (6 studies); TICSmodified
(<28/50) sensitivity: 0.91, specificity: 0.91 (3 studies). For MCI: TICS-modified (<33/50) sensitivity:
0.82, specificity: 0.87 (3 studies); Telephone-Montreal Cognitive Assessment (<18/22) sensitivity:
0.98, specificity: 0.69 (2 studies).
Conclusion: There is limited diagnostic accuracy evidence for the many telephonic cognitive screens
that exist. The TICS and TICS-m have the greatest supporting evidence; their test accuracy profiles
make them suitable as initial cognitive screens where face to face assessment is not possible.
