Influence of the Intensive Care Unit Environment on the Reliability of the Montreal Cognitive Assessment
Background: Neuropsychological screening becomes increasingly important for the evaluation of subarachnoid hemorrhage (SAH) and stroke patients. It is often performed during the surveillance period on the intensive (ICU), while it remains unknown, whether the distraction in this environment influenc...
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Frontiers Media S.A.
2019-07-01
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Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00734/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Martin Nikolaus Stienen Martin Nikolaus Stienen Olivia Geisseler Olivia Geisseler Julia Velz Julia Velz Nicolai Maldaner Nicolai Maldaner Martina Sebök Martina Sebök Noemi Dannecker Noemi Dannecker Yannick Rothacher Yannick Rothacher Ladina Schlosser Ladina Schlosser Nicolas Roydon Smoll Emanuela Keller Emanuela Keller Peter Brugger Peter Brugger Luca Regli Luca Regli |
spellingShingle |
Martin Nikolaus Stienen Martin Nikolaus Stienen Olivia Geisseler Olivia Geisseler Julia Velz Julia Velz Nicolai Maldaner Nicolai Maldaner Martina Sebök Martina Sebök Noemi Dannecker Noemi Dannecker Yannick Rothacher Yannick Rothacher Ladina Schlosser Ladina Schlosser Nicolas Roydon Smoll Emanuela Keller Emanuela Keller Peter Brugger Peter Brugger Luca Regli Luca Regli Influence of the Intensive Care Unit Environment on the Reliability of the Montreal Cognitive Assessment Frontiers in Neurology Montreal Cognitive Assessment intensive care unit reliability neuropsychology cognitive evaluation neuropsychological assessment |
author_facet |
Martin Nikolaus Stienen Martin Nikolaus Stienen Olivia Geisseler Olivia Geisseler Julia Velz Julia Velz Nicolai Maldaner Nicolai Maldaner Martina Sebök Martina Sebök Noemi Dannecker Noemi Dannecker Yannick Rothacher Yannick Rothacher Ladina Schlosser Ladina Schlosser Nicolas Roydon Smoll Emanuela Keller Emanuela Keller Peter Brugger Peter Brugger Luca Regli Luca Regli |
author_sort |
Martin Nikolaus Stienen |
title |
Influence of the Intensive Care Unit Environment on the Reliability of the Montreal Cognitive Assessment |
title_short |
Influence of the Intensive Care Unit Environment on the Reliability of the Montreal Cognitive Assessment |
title_full |
Influence of the Intensive Care Unit Environment on the Reliability of the Montreal Cognitive Assessment |
title_fullStr |
Influence of the Intensive Care Unit Environment on the Reliability of the Montreal Cognitive Assessment |
title_full_unstemmed |
Influence of the Intensive Care Unit Environment on the Reliability of the Montreal Cognitive Assessment |
title_sort |
influence of the intensive care unit environment on the reliability of the montreal cognitive assessment |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2019-07-01 |
description |
Background: Neuropsychological screening becomes increasingly important for the evaluation of subarachnoid hemorrhage (SAH) and stroke patients. It is often performed during the surveillance period on the intensive (ICU), while it remains unknown, whether the distraction in this environment influences the results. We aimed to study the reliability of the Montreal Cognitive Assessment (MoCA) in the ICU environment.Methods: Consecutive stable patients with recent brain injury (tumor, trauma, stroke, etc.) were evaluated twice within 36 h using official parallel versions of the MoCA (ΔMoCA). The sequence of assessment was randomized into (a) busy ICU first or (b) quiet office first with subsequent crossover. For repeated MoCA, we determined sequence, period, location effects, and the intraclass correlation coefficient (ICC).Results:N = 50 patients were studied [n = 30 (60%) male], with a mean age of 57 years. The assessment's sequence [“ICU first” mean ΔMoCA −1.14 (SD 2.34) vs. “Office first” −0.73 (SD 1.52)] did not influence the MoCA (p = 0.47). On the 2nd period, participants scored 0.96 points worse (SD 2.01; p = 0.001), indicating no MoCA learning effect but a possible difference in parallel versions. There was no location effect (p = 0.31) with ΔMoCA between locations (Office minus ICU) of −0.32 (SD 2.21). The ICC for repeated MoCA was 0.87 (95% CI 0.79–0.92).Conclusions: The reliability of the MoCA was excellent, independent from the testing environment being ICU or office. This finding is helpful for patient care and studies investigating the effect of a therapeutic intervention on the neuropsychological outcome after SAH, stroke or traumatic brain injury. |
topic |
Montreal Cognitive Assessment intensive care unit reliability neuropsychology cognitive evaluation neuropsychological assessment |
url |
https://www.frontiersin.org/article/10.3389/fneur.2019.00734/full |
work_keys_str_mv |
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doaj-b3b9bdda6d4d4f09bed82047e70b06952020-11-25T01:52:55ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-07-011010.3389/fneur.2019.00734450240Influence of the Intensive Care Unit Environment on the Reliability of the Montreal Cognitive AssessmentMartin Nikolaus Stienen0Martin Nikolaus Stienen1Olivia Geisseler2Olivia Geisseler3Julia Velz4Julia Velz5Nicolai Maldaner6Nicolai Maldaner7Martina Sebök8Martina Sebök9Noemi Dannecker10Noemi Dannecker11Yannick Rothacher12Yannick Rothacher13Ladina Schlosser14Ladina Schlosser15Nicolas Roydon Smoll16Emanuela Keller17Emanuela Keller18Peter Brugger19Peter Brugger20Luca Regli21Luca Regli22Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandClinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandClinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandNeuropsychology Unit, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandClinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandClinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandClinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandClinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandNeuropsychology Unit, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandClinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandNeuropsychology Unit, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandClinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandNeuropsychology Unit, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandSchool of Population and Global Health, University of Melbourne, Carlton, VIC, AustraliaDepartment of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandClinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandClinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandNeuropsychology Unit, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandClinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandBackground: Neuropsychological screening becomes increasingly important for the evaluation of subarachnoid hemorrhage (SAH) and stroke patients. It is often performed during the surveillance period on the intensive (ICU), while it remains unknown, whether the distraction in this environment influences the results. We aimed to study the reliability of the Montreal Cognitive Assessment (MoCA) in the ICU environment.Methods: Consecutive stable patients with recent brain injury (tumor, trauma, stroke, etc.) were evaluated twice within 36 h using official parallel versions of the MoCA (ΔMoCA). The sequence of assessment was randomized into (a) busy ICU first or (b) quiet office first with subsequent crossover. For repeated MoCA, we determined sequence, period, location effects, and the intraclass correlation coefficient (ICC).Results:N = 50 patients were studied [n = 30 (60%) male], with a mean age of 57 years. The assessment's sequence [“ICU first” mean ΔMoCA −1.14 (SD 2.34) vs. “Office first” −0.73 (SD 1.52)] did not influence the MoCA (p = 0.47). On the 2nd period, participants scored 0.96 points worse (SD 2.01; p = 0.001), indicating no MoCA learning effect but a possible difference in parallel versions. There was no location effect (p = 0.31) with ΔMoCA between locations (Office minus ICU) of −0.32 (SD 2.21). The ICC for repeated MoCA was 0.87 (95% CI 0.79–0.92).Conclusions: The reliability of the MoCA was excellent, independent from the testing environment being ICU or office. This finding is helpful for patient care and studies investigating the effect of a therapeutic intervention on the neuropsychological outcome after SAH, stroke or traumatic brain injury.https://www.frontiersin.org/article/10.3389/fneur.2019.00734/fullMontreal Cognitive Assessmentintensive care unitreliabilityneuropsychologycognitive evaluationneuropsychological assessment |