计算机自适应认知障碍筛查系统的构建  

Development of a Computerized Adaptive Testing System For Cognitive Impairment Screening

作　　者：谢海群[1] 王玉凯[1] 黄淑云[1] 林碧清[1] 张薇平[1] 黄嘉星[1] 黄秋兰[1] 胡才有 陈露诗[1] 田秋姣 卢健聪[1] 杨建荣[2] 章成国[1] 吕泽平[3] 

机构地区：[1]佛山市第一人民医院,528000 [2]广西江滨医院,530021 [3]国家康复辅具研究中心附属康复医院,100176

出　　处：《中国老年保健医学》2017年第4期30-32,共3页Chinese Journal of Geriatric Care

基　　金：十二五国家支撑计划课题(项目编号:2015BAI06B02);广东省自然基金(项目编号:S2012010009715)

摘　　要：目的构建应用于社区的计算机自适应认知功能障碍筛查系统(Computerized Adaptive Testing for Cognition,CATCog),搭建社区老人认知功能信息管理平台。方法利用目前现行的认知障碍筛查量表(MMSE,MoCA,画钟测验)和基于项目反应理论的计算机化自适应测试技术,构建人机交互、自适应的认知功障碍筛查系统。对CAT-Cog系统进行内部一致性、重测信度检验、效度分析。结果显示CAT-Cog信效度达85%以上,其中Cronbach’sα为0.956,4周后重测信度Pearson相关系数为0.853。CAT-Cog系统与传统纸笔原测试(MMSE,MoCA,画钟测验)的相关系数为0.792~0.876。CAT-Cog鉴别认知正常者与AD患者的敏感度为89.7%,特异度为88.0%。鉴别认知正常者和轻度认知障碍者的敏感度为88.9%,特异度为79.0%。将CAT-Cog系统与网络信息平台结合,构建了社区老人认知功能信息管理平台。结论 CAT-Cog系统结合互联网信息管理平台,可更高效、个体化、信息化筛查认知障碍和实现疾病管理,适用于社区和各级医疗机构普及和推广。Objectives The purpose of this study is to development of a computerized adaptive testing and management system for elderly with cognitive Impairment in community. Methods On the basis of widely used scales （ MMSE, MoCA, clock drawing test）, computerized adaptive testing technology and item response theory, a computerized adaptive testing system was developed. The internal consistency, test-retest reliability and validity of the CAT-Cog were analyzed. Results The reliability and validity of CAT- Cog were over 85% , Cronbach＇s otwas 0. 956. After four weeks, test-retest reliability analysis was conducted. Correlation coefficient of Pearson was 0. 853. The correlation coefficient between CAT-Cog system and traditional paper based tests （ MMSE, MoCA, drawing clock test） is 0. 792 - 0. 876. The sensitivity of CAT-Cog for discriminating normal subjects and AD patients was 85.7% and specificity was 88%. The sensitivity for discriminating normal subjects and mild cognitive impairment was 88.9% , and the specificity was 79% . Combining the CAT-Cog system and the on-line network, the cognitive function information management platform for community elderly is constructed. Conclusion CAT-Cog system, combined with on-line information management platform, can be more efficient, individualized, information-based, screening for cognitive impairment and achieving disease management, as well as applying for community and clinical institutes.

关 键 词：认知障碍 计算机 社区 自适应 痴呆 

分 类 号：R749.1[医药卫生—神经病学与精神病学] TP399-C8[医药卫生—临床医学]