Sage Journals: Discover world-class research

Abstract

Objective:

The aim of this study is to examine the psychometric properties of the Spanish version of the Oxford Cognitive Screen in a subacute stroke population.

Participants and setting:

Fifty-seven subacute stroke outpatients and 54 healthy individuals were recruited in Alicante province, Spain.

Main measure:

The Oxford Cognitive Screen.

Other measures:

The Montreal Cognitive Assessment, the Barcelona test, and the Barthel Index.

Design:

A validation study was conducted to analyze the inter-rater, intra-rater, test–retest, and internal consistency of the Spanish version of the Oxford Cognitive Screen. Concurrent validity was assessed using the Montreal Cognitive Assessment and the Barcelona test, and divergent validity using the Barthel index. Discriminant indices such as the sensitivity, specificity, predictive values, and optimal cut-offs were also estimated.

Results:

The subtests of the Spanish version of the Oxford Cognitive Screen showed excellent estimates for the inter-reliability (intraclass correlation coefficient (ICC) = 0.790 to 1.000; r_s = 0.693 to 1.000), and acceptable-good for intra-reliability (ICC = 0.181 to 0.990) and test–retest reliability (r_s = 0.173 to 0.971). Internal consistency was also excellent (standardized Cronbach’s α = 0.907). Spearman correlations for the concurrent validity were low-strong (r_s = −0.193 to 0.95) and low-moderate (r_s = −0.091 to 0.443) for divergent validity. The optimal cut-offs estimated for the subtests of the Spanish version of the Oxford Cognitive Screen showed good-high specificity (66.7%–100%) and positive predictive value (67.9%–100%), and low-good sensitivity (14.8%–83.3%) and moderate-good negative predictive value (53.5%–76.6%). Discriminant power as measured by the area under the curve indicated acceptable-good values (0.397 to 0.894).

Conclusion:

Our findings support that the Spanish version of the Oxford Cognitive Screen is a reliable and valid tool for screening cognitive impairments in subacute stroke patients.

Keywords

Stroke psychometric properties validation assessment Oxford Cognitive Screen

Get full access to this article

View all access options for this article.

References

Bernhardt

Hayward

Kwakkel

et al . Agreed definitions and a shared vision for new standards in stroke recovery research: the Stroke Recovery and Rehabilitation Roundtable taskforce. Int J Stroke 2017; 12: 444–450.

Moran

Fletcher

Feltham

et al . Fatigue, psychological and cognitive impairment following transient ischaemic attack and minor stroke: a systematic review. Eur J Neurol 2014; 21(10): 1258–1267.

Sun

J-H

Tan

J-T.

Post-stroke cognitive impairment: epidemiology, mechanisms and management. Ann Transl Med 2014; 2(8): 80.

Nys

GMS

van Zandvoort

de Kort

et al . Cognitive disorders in acute stroke: prevalence and clinical determinants. Cerebrovasc Dis 2007; 23(5–6): 408–416.

Kalaria

Akinyemi

Ihara

Stroke injury, cognitive impairment and vascular dementia. Biochim Biophys Acta 2016; 1862(5): 915–925.

Jokinen

Melkas

Ylikoski

et al . Post-stroke cognitive impairment is common even after successful clinical recovery. Eur J Neurol 2015; 22(9): 1288–1294.

Nakling

Aarsland

Næss

et al . Cognitive deficits in chronic stroke patients: neuropsychological assessment, depression, and self-reports. Dement Geriatr Cogn Dis Extra 2017; 7(2): 283–296.

Burton

Tyson

SF.

Screening for cognitive impairment after stroke: a systematic review of psychometric properties and clinical utility. J Rehabil Med 2015; 47(3): 193–203.

Tang

Amiesimaka

Harrison

et al . Longitudinal effect of stroke on cognition: a systematic review. J Am Heart Assoc 2018; 7(2): e006443.

10.

McDonnell

Bryan

Smith

et al . Assessing cognitive impairment following stroke. J Clin Exp Neuropsychol 2011; 33(9): 945–953.

11.

Demeyere

Riddoch

Slavkova

et al . The Oxford Cognitive Screen (OCS): validation of a stroke-specific short cognitive screening tool. Psychol Assess 2015; 27(3): 883–894.

12.

Wild

Grove

Martin

et al . Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health 2005; 8(2): 94–104.

13.

Diez-Tejedor

Guía oficial para el diagnóstico y tratamiento de ictus. Spanish Neurology Society, http://www.dep4.san.gva.es/contenidos/urg/archivos/guias/2004/Guia%20SEN%20ictus.pdf (accessed 10 January 2018).

14.

Kong

Lam

et al . The Hong Kong version of the Oxford Cognitive Screen (HK-OCS): validation study for Cantonese-speaking chronic stroke survivors. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2016; 23(5): 530–548.

15.

Lozano

Hernández-Ferrándiz

Turró-Garriga

et al . Validación del Montreal Cognitive Assessment (MoCA): test de cribado para el deterioro cognitivo leve. Datos Preliminares. Alzheimer Real Invest Demenc 2009; 43: 4–11.

16.

Peña-Casanova

Programa integrado de exploración neuropsicológica test—Barcelona-revisado. 2nd ed. Barcelona: Masson, 2005.

17.

Cid-Ruzafa

Damián-Moreno

Valoración de la discapacidad física: el índice de Barthel. Rev Esp Salud Pública 1997; 71: 127–137.

18.

Koo

MY.

A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 15(2): 155–163.

19.

Cohen

Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, MI: Lawrence Erlbaum, 1988.

20.

Terwee

Bot

de Boer

et al . Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007; 60(1): 34–42.

21.

Imai

King

et al . MatchIt: nonparametric preprocessing for parametric causal inference. J Stat Softw 2011; 42: 1–28.

22.

López-Ratón

Rodríguez-Álvarez

Cadarso-Suárez

OptimalCutpoints: an R package for selecting optimal cutpoints in diagnostic tests. J Stat Softw 2014; 61: 1–36.

23.

Youden

WJ.

Index for rating diagnostic tests. Cancer 1950; 3(1): 32–35.

24.

Eusebi

Diagnostic accuracy measures. Cerebrovasc Dis 2013; 36: 267–272.

25.

Hajian-Tilaki

Receiver operating characteristic (ROC) curve analysis for medical diagnostic test evaluation. Caspian J Intern Med 2013; 4(2): 627–635.

26.

Lees

Selvarajah

Fenton

et al . Test accuracy of cognitive screening tests for diagnosis of dementia and multidomain cognitive impairment in stroke. Stroke 2014; 45(10): 3008–3018.

27.

Chan

Khan

Oliver

et al . Underestimation of cognitive impairments by the Montreal Cognitive Assessment (MoCA) in an acute stroke unit population. J Neurol Sci 2014; 343(1–2): 176–179.

28.

Chan

Altendorff

Healy

et al . The test accuracy of the Montreal Cognitive Assessment (MoCA) by stroke lateralisation. J Neurol Sci 2017; 373: 100–104.

29.

Demeyere

Riddoch

Slavkova

et al . Domain-specific versus generalized cognitive screening in acute stroke. J Neurol 2016; 263(2): 306–315.

30.

Middleton

Lam

Fahmi

et al . Frequency of domain-specific cognitive impairment in sub-acute and chronic stroke. NeuroRehabilitation 2014; 34(2): 305–312.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.50 MB

Validation of the Spanish version of the Oxford Cognitive Screen (S-OCS): psychometric properties of a short cognitive stroke-specific screening tool