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Psychometrics and diagnostics of Italian cognitive screening tests: a systematic review

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A Correction to this article was published on 23 July 2022

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Abstract

Background

Cognitive screening tests (CSTs) are crucial to neuropsychological diagnostics, and thus need to be featured by robust psychometric and diagnostic properties. However, CSTs happen not to meet desirable statistical standards, negatively affecting their level of recommendations and applicability. This study aimed at (a) providing an up-to-date compendium of available CSTs in Italy, (b) report their psychometric and diagnostic properties, and (c) address related limitations.

Methods

This review was implemented by consulting Preferred Reporting Items for Systematic Reviews and Meta-Analyses and pre-registered on the International Prospective Register of Systematic Reviews. Standardization and usability studies focusing on norms, validity, reliability, or sensitivity/specificity (and derived metrics) in adults were considered for eligibility. Quality assessment was performed by means of an ad hoc checklist collecting information on sampling, psychometrics/diagnostics, norming, and feasibility.

Results

Sixty studies were included out of an initial N = 683. Identified CSTs (N = 40) were classified into general, domain-, and disease-specific (N = 17, 7, and 16, respectively), the latter being less statistically robust than remaining categories. Validity and reliability evidence was provided for 29 and 26 CSTs, respectively, sensitivity/specificity for 20 and norms for 33. Prevalence- and post-test-based diagnostic metrics were seldomly represented; factorial structures, ceiling/floor effects, and acceptability rarely investigated; content, face, and ecological validity never assessed.

Discussion

Although available Italian CSTs overall met basic psychometric/diagnostic requirements, their statistical profile often proved to be poor on several properties that are desirable for clinical applications, with a few exceptions among general and domain-specific ones.

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Acknowledgements

The authors would like to thank Dr. Francesca Crespi for her contributions.

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Authors and Affiliations

  1. PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy

    Edoardo Nicolò Aiello

  2. Department of Psychology, University of Milano-Bicocca, Milano, Italy

    Sara Rimoldi & Nadia Bolognini

  3. Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milano, Italy

    Nadia Bolognini

  4. Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy

    Ildebrando Appollonio

  5. IRCCS San Camillo Hospital, Venice, Italy

    Giorgio Arcara

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  1. Edoardo Nicolò Aiello
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Aiello, E.N., Rimoldi, S., Bolognini, N. et al. Psychometrics and diagnostics of Italian cognitive screening tests: a systematic review. Neurol Sci 43, 821–845 (2022). https://doi.org/10.1007/s10072-021-05683-4

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