Contributions
Abstract: P1095
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology
Objective: Feasibility study of the Brief International Cognitive Assessment in MS (BICAMS) for practice-based neurologists in Germany.
Background: There is evidence that in multiple sclerosis (MS) cognitive decline negatively affects well-being, vocational status and adherence to therapy. BICAMS was proposed to facilitate access to a standardized cognitive screening tool even for practice-based neurologists. However allocated time per patient is a critical issue in Germany meaning that neuropsychological screening in most of the cases has to be performed by trained MS study nurses.
Methods: Data were collected in a multi-centre study across 60 centres in Germany. Study nurses were trained for correct application and scoring of the three BICAMS tests (SDMT, BVMT-R and VLMT as German version of CVLT-II). All scored tests were sent to an independent neuropsychological centre for cross-validation by two independent experts.
Results: Data of 1491 patients (Age: M=42.8, SD= 11.2; 1103 female) have been analysed. Mean application time of BICAMS was 19 min (SD=10). Due to mistakes related to test application and scoring several datasets had to be excluded from all further analyses: SDMTss (sum score): 11.5%; SDMTz (z-score): 18.8%; VLMTss (sum score): 8.0%; VLMTp (percentile): 36.1%; BVMTss (sum score): 18.6% and BVMTp (percentile): 21.1%. For the remaining dataset intraclass correlation coefficients (ICCs) were calculated as estimate for interrater-reliability for each BICAMS test between ratings of study nurses and two experts. The ICCs were as follows: SDMTz: 0.95; VLMTp: 0.99 and BVMTp: 0.96. The ICCs between experts were as follows: SDMTz: 0.99; VLMTp: 0.99 and BVMTp: 0.99.
Conclusion: BICAMS is a brief cognitive screening tool that can be recommended for clinical practice. However, it is important to notice that although interrater reliability was high for the finally adjusted dataset, a percentage of 8.0% up to 36.1% of the dataset had to be excluded due to mistakes in test application (SDMT:9.5%; VLMT:0.1%; BVMT:16.0%) or scoring (calculating sum scores: 12.5%; calculation of z-scores or percentiles: 37,7%). According to our findings, application of BICAMS is feasible after careful instruction of non-psychological personnel such as nurses. However, due to the much higher amount of scoring mistakes final rating of test results should be performed rather centrally by experts or in a completely standardized electronic manner.
Disclosure:
Filser, M.: nothing to disclose
Ullrich, S.: nothing to disclose
Lassek, C.: has received travel grants, speaker's honoraria, financial research support and consultancy fees from Teva, Merck Serono, Genzyme -Sanofi, Novartis, Bayer, Biogen Idec.
Baetge, S.: nothing to disclose
Renner, A.: nothing to disclose
Penner, I.K.: has received honoraria for speaking at scientific meetings, serving at scientific advisory boards and consulting activities from Adamas Pharma, Almirall, Bayer Pharma, Biogen, Genzyme, Merck Serono, Novartis and Teva. She has received research support from Merck Serono, Novartis, the German MS Society and Teva
Abstract: P1095
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology
Objective: Feasibility study of the Brief International Cognitive Assessment in MS (BICAMS) for practice-based neurologists in Germany.
Background: There is evidence that in multiple sclerosis (MS) cognitive decline negatively affects well-being, vocational status and adherence to therapy. BICAMS was proposed to facilitate access to a standardized cognitive screening tool even for practice-based neurologists. However allocated time per patient is a critical issue in Germany meaning that neuropsychological screening in most of the cases has to be performed by trained MS study nurses.
Methods: Data were collected in a multi-centre study across 60 centres in Germany. Study nurses were trained for correct application and scoring of the three BICAMS tests (SDMT, BVMT-R and VLMT as German version of CVLT-II). All scored tests were sent to an independent neuropsychological centre for cross-validation by two independent experts.
Results: Data of 1491 patients (Age: M=42.8, SD= 11.2; 1103 female) have been analysed. Mean application time of BICAMS was 19 min (SD=10). Due to mistakes related to test application and scoring several datasets had to be excluded from all further analyses: SDMTss (sum score): 11.5%; SDMTz (z-score): 18.8%; VLMTss (sum score): 8.0%; VLMTp (percentile): 36.1%; BVMTss (sum score): 18.6% and BVMTp (percentile): 21.1%. For the remaining dataset intraclass correlation coefficients (ICCs) were calculated as estimate for interrater-reliability for each BICAMS test between ratings of study nurses and two experts. The ICCs were as follows: SDMTz: 0.95; VLMTp: 0.99 and BVMTp: 0.96. The ICCs between experts were as follows: SDMTz: 0.99; VLMTp: 0.99 and BVMTp: 0.99.
Conclusion: BICAMS is a brief cognitive screening tool that can be recommended for clinical practice. However, it is important to notice that although interrater reliability was high for the finally adjusted dataset, a percentage of 8.0% up to 36.1% of the dataset had to be excluded due to mistakes in test application (SDMT:9.5%; VLMT:0.1%; BVMT:16.0%) or scoring (calculating sum scores: 12.5%; calculation of z-scores or percentiles: 37,7%). According to our findings, application of BICAMS is feasible after careful instruction of non-psychological personnel such as nurses. However, due to the much higher amount of scoring mistakes final rating of test results should be performed rather centrally by experts or in a completely standardized electronic manner.
Disclosure:
Filser, M.: nothing to disclose
Ullrich, S.: nothing to disclose
Lassek, C.: has received travel grants, speaker's honoraria, financial research support and consultancy fees from Teva, Merck Serono, Genzyme -Sanofi, Novartis, Bayer, Biogen Idec.
Baetge, S.: nothing to disclose
Renner, A.: nothing to disclose
Penner, I.K.: has received honoraria for speaking at scientific meetings, serving at scientific advisory boards and consulting activities from Adamas Pharma, Almirall, Bayer Pharma, Biogen, Genzyme, Merck Serono, Novartis and Teva. She has received research support from Merck Serono, Novartis, the German MS Society and Teva