ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1571

Validity Evidence Supports the Use of Automated Neuropsychological Assessment Metrics (ANAM) as a Screening Tool for Cognitive Impairment in Patients with Systemic Lupus Erythematosus

Oshrat Tayer-Shifman1, Robin Green 2, Dorcas Beaton 3, Lesley Ruttan 2, Joan Wither 4, Maria Tartaglia 5, Mahta Kakvan 1, Sabrina Lombardi 2, Nicole Anderson 1, Jiandong Su 1, Dennisse Bonilla 1, Moe Zandy 1, May Choi 6, Marvin Fritzler 6 and Zahi Touma 7, 1University Health Network, University of Toronto, Toronto, ON, Canada, 2University Health Network, Toronto, ON, Canada, 3St. Michael's Hospital, Toronto, ON, Canada, 4University Health Network, Krembil Research Institute, Toronto, ON, Canada, 5University Health Network, University of Toronto, Toronto, ON, Canada, 6Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, 7University Health Network, University of Toronto, Toronto, Canada

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: SLE

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Monday, November 11, 2019

Session Title: SLE – Clinical Poster II: Comorbidities

Session Type: Poster Session (Monday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Cognitive impairment (CI) is highly prevalent in Systemic Lupus Erythematosus (SLE). Screening for CI in SLE may be delayed, if relying on the American College of Rheumatology (ACR) neuropsychological battery (NB), which is time- and resource- intensive. The Automated Neuropsychological Assessment Metrics (ANAM) is a quick and low-cost computer-based screening tool for CI. The overarching aim of this study was to assess the performance of the ANAM as a screening tool for CI in SLE patients employing the ACR NB as the gold standard. The specific objective were to: (a) determine the ability of the ANAM to differentiate between SLE patients with and without CI, (b) assess the ability of selected ANAM subtests to accurately identify CI, and (c)  derive an ANAM composite index and cut-off to facilitate its use.

Methods: : Between 2016 and 2019, 211 consecutive adult SLE patients were administered the ACR NB and the ANAM on the same day. Using age- and gender-stratified normative data, patients were classified on the ACR NB as having CI if a z-score of ≤-1.5 was observed in ≥ 2 domains; or non-CI if no domain had a z-score of ≤-1.5. First, discriminative validity of the ANAM was assessed by its ability to differentiate between CI and non-CI patients compared to the ACR NB. All 15 ANAM subtests and their scores (percentage of correct responses [PCT], mean reaction time [MR], throughput [TP], and coefficient of variation [CV]) were studied. Second, we developed 6 ANAM models and the most discriminatory subtests and scores within each model were selected using logistic regression analyses. The area under the receiver operating characteristics curve (AUC) was calculated to establish ANAM models construct validity against the ACR NB. Third, an ANAM composite index and cut-off were derived for the best selected model using the sum of the subtests’ scores multiplied by their parameter estimate from the logistic regression. The sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (PPV) of the ANAM composite index and cut-off, to differentiate CI from non-CI were evaluated.

Results: Patients with non-CI performed better on the majority of ANAM subtests in PCT, MR and TP scores compared to those with CI, providing support for ANAM discriminative validity. CI was accurately identified by the best ANAM model (Table 1) with an excellent AUC of 84% [95% confidence interval: 0.84, 0.87] (Figure 1), providing support for the construct validity of the ANAM model using 8 selected ANAM subtests and corresponding scores. The derived composite index (equation provided in Table 1) demonstrated good performance with AUC of 79%. The proposed cut-off yielded Se, Sp, PPV and NPV of 80%, 70%, 83% and 65%, respectively. Figure 2 demonstrates the performance of the composite index over different cut-off values.

Conclusion: This study provides support for the validity of the ANAM along with 8 selected subtests for the screening of CI in adult SLE in the selected model. We derived an ANAM composite index and a cut-off to serve as a summary measure of cognitive performance of SLE patients. This will enhance the applicability and interpretation of the ANAM in clinical practice.


Disclosure: O. Tayer-Shifman, None; R. Green, None; D. Beaton, None; L. Ruttan, None; J. Wither, None; M. Tartaglia, None; M. Kakvan, None; S. Lombardi, None; N. Anderson, None; J. Su, None; D. Bonilla, None; M. Zandy, None; M. Choi, None; M. Fritzler, Alexion Canada, 7, BioRad, 5, Dr. Fooke Laboratorien GmbH, 5, Euroimmun GmbH, 5, 7, ImmunoConcepts, 7, Inova Diagnostics, 5, 7, 8, Inova Diagnostics Inc. San diego, CA, 5, Inova Dx, Mikrogen GmbH, 5, Werfen International, 5; Z. Touma, None.

To cite this abstract in AMA style:

Tayer-Shifman O, Green R, Beaton D, Ruttan L, Wither J, Tartaglia M, Kakvan M, Lombardi S, Anderson N, Su J, Bonilla D, Zandy M, Choi M, Fritzler M, Touma Z. Validity Evidence Supports the Use of Automated Neuropsychological Assessment Metrics (ANAM) as a Screening Tool for Cognitive Impairment in Patients with Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/validity-evidence-supports-the-use-of-automated-neuropsychological-assessment-metrics-anam-as-a-screening-tool-for-cognitive-impairment-in-patients-with-systemic-lupus-erythematosus/. Accessed April 12, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2019 ACR/ARP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/validity-evidence-supports-the-use-of-automated-neuropsychological-assessment-metrics-anam-as-a-screening-tool-for-cognitive-impairment-in-patients-with-systemic-lupus-erythematosus/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.