【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。更多还原

【Abstract】 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 CATCog were over 85%,Cronbach’s αwas 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.更多还原