The SIST-M

Predictive validity of a brief structured clinical dementia rating interview

Olivia I. Okereke, Norberto Pantoja-Galicia, Maura Copeland, Bradley T. Hyman, Taylor Wanggaard, Marilyn S. Albert, Rebecca Betensky, Deborah Blacker

Research output: Contribution to journalArticle

Abstract

Background: We have previously established the reliability and cross-sectional validity of the SIST-M (Structured Interview and Scoring Tool-Massachusetts Alzheimer's Disease Research Center), a shortened version of an instrument shown to predict progression to Alzheimer disease (AD), even among persons with very mild cognitive impairment (vMCI). Objective: To test the predictive validity of the SIST-M. Methods: Participants were 342 community-dwelling, nondemented older adults in a longitudinal study. Baseline Clinical Dementia Rating (CDR) ratings were determined by either (1) clinician interviews or (2) a previously developed computer algorithm based on 60 questions (of a possible 131) extracted from clinician interviews. We developed age+sex+education-adjusted Cox proportional hazards models using CDR-sum-of-boxes (CDR-SB) as the predictor, where CDR-SB was determined by either a clinician interview or an algorithm; models were run for the full sample (n=342) and among those jointly classified as vMCI using clinician-based and algorithm-based CDR ratings (n=156). We directly compared predictive accuracy using time-dependent receiver operating characteristic (ROC) curves. Results: AD hazard ratios (HRs) were similar for clinician-based and algorithm-based CDR-SB: for a 1-point increment in CDR-SB, the respective HRs [95% confidence interval (CI)] were 3.1 (2.5, 3.9) and 2.8 (2.2, 3.5); among those with vMCI, the respective HRs (95% CI) were 2.2 (1.6, 3.2) and 2.1 (1.5, 3.0). Similarly high predictive accuracy was achieved: the concordance probability (weighted average of the area-under-the-ROC curves) over follow-up was 0.78 versus 0.76 using clinician-based versus algorithm-based CDR-SB. Conclusion: CDR scores based on items from this shortened interview had high predictive ability for AD-comparable to that using a lengthy clinical interview.

Original languageEnglish (US)
Pages (from-to)225-231
Number of pages7
JournalAlzheimer Disease and Associated Disorders
Volume26
Issue number3
DOIs
StatePublished - Jul 1 2012

Fingerprint

Dementia
Interviews
Alzheimer Disease
ROC Curve
Confidence Intervals
Independent Living
Aptitude
Sex Education
Proportional Hazards Models
Longitudinal Studies
Research
Cognitive Dysfunction

Keywords

  • Alzheimer disease
  • CDR
  • dementia
  • instrument
  • mild cognitive impairment
  • prediction
  • psychometric
  • questionnaire
  • validity

ASJC Scopus subject areas

  • Clinical Psychology
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Okereke, O. I., Pantoja-Galicia, N., Copeland, M., Hyman, B. T., Wanggaard, T., Albert, M. S., ... Blacker, D. (2012). The SIST-M: Predictive validity of a brief structured clinical dementia rating interview. Alzheimer Disease and Associated Disorders, 26(3), 225-231. https://doi.org/10.1097/WAD.0b013e318231cd30

The SIST-M : Predictive validity of a brief structured clinical dementia rating interview. / Okereke, Olivia I.; Pantoja-Galicia, Norberto; Copeland, Maura; Hyman, Bradley T.; Wanggaard, Taylor; Albert, Marilyn S.; Betensky, Rebecca; Blacker, Deborah.

In: Alzheimer Disease and Associated Disorders, Vol. 26, No. 3, 01.07.2012, p. 225-231.

Research output: Contribution to journalArticle

Okereke, OI, Pantoja-Galicia, N, Copeland, M, Hyman, BT, Wanggaard, T, Albert, MS, Betensky, R & Blacker, D 2012, 'The SIST-M: Predictive validity of a brief structured clinical dementia rating interview', Alzheimer Disease and Associated Disorders, vol. 26, no. 3, pp. 225-231. https://doi.org/10.1097/WAD.0b013e318231cd30
Okereke, Olivia I. ; Pantoja-Galicia, Norberto ; Copeland, Maura ; Hyman, Bradley T. ; Wanggaard, Taylor ; Albert, Marilyn S. ; Betensky, Rebecca ; Blacker, Deborah. / The SIST-M : Predictive validity of a brief structured clinical dementia rating interview. In: Alzheimer Disease and Associated Disorders. 2012 ; Vol. 26, No. 3. pp. 225-231.
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abstract = "Background: We have previously established the reliability and cross-sectional validity of the SIST-M (Structured Interview and Scoring Tool-Massachusetts Alzheimer's Disease Research Center), a shortened version of an instrument shown to predict progression to Alzheimer disease (AD), even among persons with very mild cognitive impairment (vMCI). Objective: To test the predictive validity of the SIST-M. Methods: Participants were 342 community-dwelling, nondemented older adults in a longitudinal study. Baseline Clinical Dementia Rating (CDR) ratings were determined by either (1) clinician interviews or (2) a previously developed computer algorithm based on 60 questions (of a possible 131) extracted from clinician interviews. We developed age+sex+education-adjusted Cox proportional hazards models using CDR-sum-of-boxes (CDR-SB) as the predictor, where CDR-SB was determined by either a clinician interview or an algorithm; models were run for the full sample (n=342) and among those jointly classified as vMCI using clinician-based and algorithm-based CDR ratings (n=156). We directly compared predictive accuracy using time-dependent receiver operating characteristic (ROC) curves. Results: AD hazard ratios (HRs) were similar for clinician-based and algorithm-based CDR-SB: for a 1-point increment in CDR-SB, the respective HRs [95{\%} confidence interval (CI)] were 3.1 (2.5, 3.9) and 2.8 (2.2, 3.5); among those with vMCI, the respective HRs (95{\%} CI) were 2.2 (1.6, 3.2) and 2.1 (1.5, 3.0). Similarly high predictive accuracy was achieved: the concordance probability (weighted average of the area-under-the-ROC curves) over follow-up was 0.78 versus 0.76 using clinician-based versus algorithm-based CDR-SB. Conclusion: CDR scores based on items from this shortened interview had high predictive ability for AD-comparable to that using a lengthy clinical interview.",
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