OBJECTIVES: 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. DESIGN:Eighty-seven subjects in the randomized controlled trial "Continuation Pharmacotherapy for Agitation of Dementia" were included in this analysis. We compared the detection in, and changes of, both agitation and psychosis, using these three instruments. A receiver operating characteristic analysis was performed to compare the performance of the three instruments in detecting global improvement. RESULTS: The instruments were equally likely to detect agitation. The NBRS was most likely to detect psychosis. Although the NPI best detected improvement in agitation, the instruments were equal for detecting improvement in psychosis. In the receiver operating characteristic 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 cutoff points for target symptom reduction. The E-BEHAVE-AD performed best at a cut point of 30% target symptom reduction and the NBRS and NPI both performed best at 50%. CONCLUSION: 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.
RCT Entities:
OBJECTIVES: 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. DESIGN: Eighty-seven subjects in the randomized controlled trial "Continuation Pharmacotherapy for Agitation of Dementia" were included in this analysis. We compared the detection in, and changes of, both agitation and psychosis, using these three instruments. A receiver operating characteristic analysis was performed to compare the performance of the three instruments in detecting global improvement. RESULTS: The instruments were equally likely to detect agitation. The NBRS was most likely to detect psychosis. Although the NPI best detected improvement in agitation, the instruments were equal for detecting improvement in psychosis. In the receiver operating characteristic 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 cutoff points for target symptom reduction. The E-BEHAVE-AD performed best at a cut point of 30% target symptom reduction and the NBRS and NPI both performed best at 50%. CONCLUSION: 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.
Authors: Kari B Kastango; Yookyung Kim; Mary Amanda Dew; Sati Mazumdar; Benoit H Mulsant; Jules Rosen; Charles F Reynolds III; Paul A Pilkonis; Bruce G Pollock Journal: Am J Geriatr Psychiatry Date: 2002 Nov-Dec Impact factor: 4.105
Authors: Bruce G Pollock; Benoit H Mulsant; Jules Rosen; Robert A Sweet; Sati Mazumdar; Ashok Bharucha; Robert Marin; N J Jacob; Kimberly A Huber; Kari B Kastango; Marci L Chew Journal: Am J Psychiatry Date: 2002-03 Impact factor: 18.112
Authors: H S Levin; W M High; K E Goethe; R A Sisson; J E Overall; H M Rhoades; H M Eisenberg; Z Kalisky; H E Gary Journal: J Neurol Neurosurg Psychiatry Date: 1987-02 Impact factor: 10.154
Authors: Zahinoor Ismail; Eric E Smith; Yonas Geda; David Sultzer; Henry Brodaty; Gwenn Smith; Luis Agüera-Ortiz; Rob Sweet; David Miller; Constantine G Lyketsos Journal: Alzheimers Dement Date: 2015-06-18 Impact factor: 21.566
Authors: Zahinoor Ismail; Byron Creese; Dag Aarsland; Helen C Kales; Constantine G Lyketsos; Robert A Sweet; Clive Ballard Journal: Nat Rev Neurol Date: 2022-01-04 Impact factor: 44.711
Authors: José Manuel Santacruz Escudero; Jonathan Beltrán; Álvaro Palacios; Claudia Marcela Chimbí; Diana Matallana; Pablo Reyes; Victor Perez-Sola; Hernando Santamaría-García Journal: Front Aging Neurosci Date: 2019-07-24 Impact factor: 5.750