Accuracy of Telephone-Based Cognitive Screening Tests: Systematic Review and Meta-Analysis

Author(s): Emma Elliott, Claire Green, David J. Llewellyn, Terence J. Quinn*

Journal Name: Current Alzheimer Research

Volume 17 , Issue 5 , 2020

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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.

Keywords: Cognitive Impairment, dementia, telephone assessment, sensitivity, specificity, cognitive screening, diagnostic accuracy.

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Article Details

VOLUME: 17
ISSUE: 5
Year: 2020
Page: [460 - 471]
Pages: 12
DOI: 10.2174/1567205017999200626201121
Price: $65

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