A Comparison of the E-BEHAVE-AD, NBRS and NPI in Quantifying Clinical Improvement in the Treatment of Agitation and Psychosis Associated with Dementia
Identifieur interne : 000E73 ( Main/Exploration ); précédent : 000E72; suivant : 000E74A Comparison of the E-BEHAVE-AD, NBRS and NPI in Quantifying Clinical Improvement in the Treatment of Agitation and Psychosis Associated with Dementia
Auteurs : Zahinoor Ismail [Canada] ; Chetachi A. Emeremni [États-Unis] ; Patricia R. Houck [États-Unis] ; Sati Mazumdar [États-Unis] ; Jules Rosen [États-Unis] ; Tarek K. Rajji [Canada] ; Bruce G. Pollock [Canada, États-Unis] ; Benoit H. Mulsant [Canada, États-Unis]Source :
- The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry [ 1064-7481 ] ; 2013.
Abstract
The aim of this study is to compare the Empirical Behavioral Rating Scale (E-BEHAVE AD), Neurobehavioral Rating Scale (NBRS), and Neuropsychiatric Interview (NPI) in detecting behavioral disturbance and psychotic symptoms in dementia and characterizing changes in response to treatment.
87 subjects in the randomized controlled trial “Continuation Pharmacotherapy for Agitation of Dementia” (CPAD) were included in this analysis. We compared the detection and changes over 12 weeks of both agitation and psychosis using these 3 instruments. A receiver operating characteristic (ROC) analysis was performed to compare the performance of the three instruments in detecting global improvement.
The instruments were equally likely to detect agitation. The NBRS was most likely to detect psychosis. While the NPI best detected improvement in agitation, the instruments were equal for detecting improvement in psychosis. In the ROC analysis for overall clinical improvement in response to treatment, there were no differences in the areas under the correlated curves for the three instruments but they demonstrated different sensitivity and specificity at different cut-off points for target symptom reduction. The E-BEHAVE-AD performed best at a cutpoint of 30% target symptom reduction and the NBRS and NPI both performed best at 50%.
The E-BEHAVE-AD, NBRS, and NPI were more similar than different in characterizing symptoms but differed in detecting response to treatment. Differences in sensitivity and specificity may lead clinicians to prefer a specific instrument, depending on their goal and the expected magnitude of response to any specific intervention.
Url:
DOI: 10.1016/j.jagp.2012.10.013
PubMed: 23290205
PubMed Central: 3499650
Affiliations:
- Canada, États-Unis
- Alberta, Ontario, Pennsylvanie
- Calgary, Pittsburgh, Toronto
- Université de Calgary, Université de Pittsburgh, Université de Toronto
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Le document en format XML
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Emeremni</name><affiliation wicri:level="4"><nlm:aff id="A4">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Houck, Patricia R" sort="Houck, Patricia R" uniqKey="Houck P" first="Patricia R." last="Houck">Patricia R. Houck</name><affiliation wicri:level="4"><nlm:aff id="A4">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Mazumdar, Sati" sort="Mazumdar, Sati" uniqKey="Mazumdar S" first="Sati" last="Mazumdar">Sati Mazumdar</name><affiliation wicri:level="4"><nlm:aff id="A4">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Rosen, Jules" sort="Rosen, Jules" uniqKey="Rosen J" first="Jules" last="Rosen">Jules Rosen</name><affiliation wicri:level="4"><nlm:aff id="A5">Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, University of Pittsburgh, Pittsburgh</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Rajji, Tarek K" sort="Rajji, Tarek K" uniqKey="Rajji T" first="Tarek K." last="Rajji">Tarek K. Rajji</name><affiliation wicri:level="1"><nlm:aff id="A1">Centre for Addiction and Mental Health, Geriatric Mental Health Program, Toronto, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Centre for Addiction and Mental Health, Geriatric Mental Health Program, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="A2">Department of Psychiatry, University of Toronto, Toronto Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Psychiatry, University of Toronto, Toronto Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Pollock, Bruce G" sort="Pollock, Bruce G" uniqKey="Pollock B" first="Bruce G." last="Pollock">Bruce G. Pollock</name><affiliation wicri:level="1"><nlm:aff id="A1">Centre for Addiction and Mental Health, Geriatric Mental Health Program, Toronto, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Centre for Addiction and Mental Health, Geriatric Mental Health Program, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="A2">Department of Psychiatry, University of Toronto, Toronto Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Psychiatry, University of Toronto, Toronto Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="A5">Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, University of Pittsburgh, Pittsburgh</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Mulsant, Benoit H" sort="Mulsant, Benoit H" uniqKey="Mulsant B" first="Benoit H." last="Mulsant">Benoit H. Mulsant</name><affiliation wicri:level="1"><nlm:aff id="A1">Centre for Addiction and Mental Health, Geriatric Mental Health Program, Toronto, Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Centre for Addiction and Mental Health, Geriatric Mental Health Program, Toronto, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="A2">Department of Psychiatry, University of Toronto, Toronto Ontario, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Psychiatry, University of Toronto, Toronto Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="A5">Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, University of Pittsburgh, Pittsburgh</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author></analytic><series><title level="j">The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry</title><idno type="ISSN">1064-7481</idno><idno type="eISSN">1545-7214</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title><p id="P1">The aim of this study is to compare the Empirical Behavioral Rating Scale (E-BEHAVE AD), Neurobehavioral Rating Scale (NBRS), and Neuropsychiatric Interview (NPI) in detecting behavioral disturbance and psychotic symptoms in dementia and characterizing changes in response to treatment.</p></sec><sec id="S2"><title>Design</title><p id="P2">87 subjects in the randomized controlled trial “Continuation Pharmacotherapy for Agitation of Dementia” (CPAD) were included in this analysis. We compared the detection and changes over 12 weeks of both agitation and psychosis using these 3 instruments. A receiver operating characteristic (ROC) analysis was performed to compare the performance of the three instruments in detecting global improvement.</p></sec><sec id="S3"><title>Results</title><p id="P3">The instruments were equally likely to detect agitation. The NBRS was most likely to detect psychosis. While the NPI best detected improvement in agitation, the instruments were equal for detecting improvement in psychosis. In the ROC analysis for overall clinical improvement in response to treatment, there were no differences in the areas under the correlated curves for the three instruments but they demonstrated different sensitivity and specificity at different cut-off points for target symptom reduction. The E-BEHAVE-AD performed best at a cutpoint of 30% target symptom reduction and the NBRS and NPI both performed best at 50%.</p></sec><sec id="S4"><title>Conclusion</title><p id="P4">The E-BEHAVE-AD, NBRS, and NPI were more similar than different in characterizing symptoms but differed in detecting response to treatment. Differences in sensitivity and specificity may lead clinicians to prefer a specific instrument, depending on their goal and the expected magnitude of response to any specific intervention.</p></sec></div></front></TEI><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Alberta</li><li>Ontario</li><li>Pennsylvanie</li></region><settlement><li>Calgary</li><li>Pittsburgh</li><li>Toronto</li></settlement><orgName><li>Université de Calgary</li><li>Université de Pittsburgh</li><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Ismail, Zahinoor" sort="Ismail, Zahinoor" uniqKey="Ismail Z" first="Zahinoor" last="Ismail">Zahinoor Ismail</name></noRegion><name sortKey="Ismail, Zahinoor" sort="Ismail, Zahinoor" uniqKey="Ismail Z" first="Zahinoor" last="Ismail">Zahinoor Ismail</name><name sortKey="Ismail, Zahinoor" sort="Ismail, Zahinoor" uniqKey="Ismail Z" first="Zahinoor" last="Ismail">Zahinoor Ismail</name><name sortKey="Mulsant, Benoit H" sort="Mulsant, Benoit H" uniqKey="Mulsant B" first="Benoit H." last="Mulsant">Benoit H. Mulsant</name><name sortKey="Mulsant, Benoit H" sort="Mulsant, Benoit H" uniqKey="Mulsant B" first="Benoit H." last="Mulsant">Benoit H. Mulsant</name><name sortKey="Pollock, Bruce G" sort="Pollock, Bruce G" uniqKey="Pollock B" first="Bruce G." last="Pollock">Bruce G. Pollock</name><name sortKey="Pollock, Bruce G" sort="Pollock, Bruce G" uniqKey="Pollock B" first="Bruce G." last="Pollock">Bruce G. Pollock</name><name sortKey="Rajji, Tarek K" sort="Rajji, Tarek K" uniqKey="Rajji T" first="Tarek K." last="Rajji">Tarek K. Rajji</name><name sortKey="Rajji, Tarek K" sort="Rajji, Tarek K" uniqKey="Rajji T" first="Tarek K." last="Rajji">Tarek K. Rajji</name></country><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Emeremni, Chetachi A" sort="Emeremni, Chetachi A" uniqKey="Emeremni C" first="Chetachi A" last="Emeremni">Chetachi A. Emeremni</name></region><name sortKey="Houck, Patricia R" sort="Houck, Patricia R" uniqKey="Houck P" first="Patricia R." last="Houck">Patricia R. Houck</name><name sortKey="Mazumdar, Sati" sort="Mazumdar, Sati" uniqKey="Mazumdar S" first="Sati" last="Mazumdar">Sati Mazumdar</name><name sortKey="Mulsant, Benoit H" sort="Mulsant, Benoit H" uniqKey="Mulsant B" first="Benoit H." last="Mulsant">Benoit H. Mulsant</name><name sortKey="Pollock, Bruce G" sort="Pollock, Bruce G" uniqKey="Pollock B" first="Bruce G." last="Pollock">Bruce G. Pollock</name><name sortKey="Rosen, Jules" sort="Rosen, Jules" uniqKey="Rosen J" first="Jules" last="Rosen">Jules Rosen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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