Academic Journal
Development of a diagnostic checklist to identify functional cognitive disorder versus other neurocognitive disorders
| Title: | Development of a diagnostic checklist to identify functional cognitive disorder versus other neurocognitive disorders |
|---|---|
| Authors: | Cabreira, V, Alty, J, Antic, S, Araujo, R, Aybek, S, Ball, HA, Baslet, G, Bhome, R, Coebergh, J, Dubois, B, Edwards, M, Filipovic, SR, Frederiksen, KS, Harbo, T, Hayhow, B, Howard, R, Huntley, J, Isaacs, JD, Lafrance, C, Larner, A, Di Lorenzo, F, Main, J, Mallam, E, Marra, C, Massano, J, Mcgrath, ER, Portela Moreira, I, Nobili, F, Pal, S, Pennington, CM, Tabuas-Pereira, M, Perez, D, Popkirov, S, Rayment, D, Rossor, M, Russo, M, Santana, I, Schott, J, Scott, EP, Taipa, R, Teodoro, T, Tinazzi, M, Tomic, S, Toniolo, S, Torring, CW, Wilkinson, T, Zeidler, M, Frostholm, L, Mcwhirter, L, Stone, J, Carson, A |
| Publisher Information: | BMJ Publishing Group |
| Publication Year: | 2025 |
| Collection: | St George's University of London: Repository |
| Description: | Background Functional cognitive disorder (FCD) poses a diagnostic challenge due to its resemblance to other neurocognitive disorders and limited biomarker accuracy. We aimed to develop a new diagnostic checklist to identify FCD versus other neurocognitive disorders. Methods The clinical checklist was developed through mixed methods: (1) a literature review, (2) a three-round Delphi study with 45 clinicians from 12 countries and (3) a pilot discriminative accuracy study in consecutive patients attending seven memory services across the UK. Items gathering consensus were incorporated into a pilot checklist. Item redundancy was evaluated with phi coefficients. A briefer checklist was produced by removing items with >10% missing data. Internal validity was tested using Cronbach’s alpha. Optimal cut-off scores were determined using receiver operating characteristic curve analysis. Results A full 11-item checklist and a 7-item briefer checklist were produced. Overall, 239 patients (143 FCD, 96 non-FCD diagnoses) were included. The checklist scores were significantly different across subgroups (FCD and other neurocognitive disorders) (F(2, 236)=313.3, p<0.001). The area under the curve was excellent for both the full checklist (0.97, 95% CI 0.95 to 0.99) and its brief version (0.96, 95% CI 0.93 to 0.98). Optimal cut-off scores corresponded to a specificity of 97% and positive predictive value of 91% for identifying FCD. Both versions showed good internal validity (>0.80). Conclusions This pilot study shows that a brief clinical checklist may serve as a quick complementary tool to differentiate patients with neurodegeneration from those with FCD. Prospective blind large-scale validation in diverse populations is warranted. |
| Document Type: | article in journal/newspaper |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 2632-6140 |
| Relation: | https://openaccess.sgul.ac.uk/id/eprint/117284/1/e000918.full.pdf; https://openaccess.sgul.ac.uk/id/eprint/117284/3/inline-supplementary-material-1.pdf; Cabreira, V; Alty, J; Antic, S; Araujo, R; Aybek, S; Ball, HA; Baslet, G; Bhome, R; Coebergh, J; Dubois, B; et al. Cabreira, V; Alty, J; Antic, S; Araujo, R; Aybek, S; Ball, HA; Baslet, G; Bhome, R; Coebergh, J; Dubois, B; Edwards, M; Filipovic, SR; Frederiksen, KS; Harbo, T; Hayhow, B; Howard, R; Huntley, J; Isaacs, JD; Lafrance, C; Larner, A; Di Lorenzo, F; Main, J; Mallam, E; Marra, C; Massano, J; Mcgrath, ER; Portela Moreira, I; Nobili, F; Pal, S; Pennington, CM; Tabuas-Pereira, M; Perez, D; Popkirov, S; Rayment, D; Rossor, M; Russo, M; Santana, I; Schott, J; Scott, EP; Taipa, R; Teodoro, T; Tinazzi, M; Tomic, S; Toniolo, S; Torring, CW; Wilkinson, T; Zeidler, M; Frostholm, L; Mcwhirter, L; Stone, J; Carson, A (2025) Development of a diagnostic checklist to identify functional cognitive disorder versus other neurocognitive disorders. BMJ NEUROLOGY OPEN, 7 (1). e000918. ISSN 2632-6140 https://doi.org/10.1136/bmjno-2024-000918 SGUL Authors: Coebergh, Jan |
| DOI: | 10.1136/bmjno-2024-000918 |
| Availability: | https://openaccess.sgul.ac.uk/id/eprint/117284/ https://openaccess.sgul.ac.uk/id/eprint/117284/1/e000918.full.pdf https://doi.org/10.1136/bmjno-2024-000918 |
| Rights: | cc_by_nc_4 |
| Accession Number: | edsbas.8CC38BA5 |
| Database: | BASE |
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We aimed to develop a new diagnostic checklist to identify FCD versus other neurocognitive disorders. Methods The clinical checklist was developed through mixed methods: (1) a literature review, (2) a three-round Delphi study with 45 clinicians from 12 countries and (3) a pilot discriminative accuracy study in consecutive patients attending seven memory services across the UK. Items gathering consensus were incorporated into a pilot checklist. Item redundancy was evaluated with phi coefficients. A briefer checklist was produced by removing items with >10% missing data. Internal validity was tested using Cronbach’s alpha. Optimal cut-off scores were determined using receiver operating characteristic curve analysis. Results A full 11-item checklist and a 7-item briefer checklist were produced. Overall, 239 patients (143 FCD, 96 non-FCD diagnoses) were included. The checklist scores were significantly different across subgroups (FCD and other neurocognitive disorders) (F(2, 236)=313.3, p<0.001). The area under the curve was excellent for both the full checklist (0.97, 95% CI 0.95 to 0.99) and its brief version (0.96, 95% CI 0.93 to 0.98). Optimal cut-off scores corresponded to a specificity of 97% and positive predictive value of 91% for identifying FCD. Both versions showed good internal validity (>0.80). Conclusions This pilot study shows that a brief clinical checklist may serve as a quick complementary tool to differentiate patients with neurodegeneration from those with FCD. Prospective blind large-scale validation in diverse populations is warranted. – Name: TypeDocument Label: Document Type Group: TypDoc Data: article in journal/newspaper – Name: Format Label: File Description Group: SrcInfo Data: application/pdf – Name: Language Label: Language Group: Lang Data: English – Name: ISSN Label: ISSN Group: ISSN Data: 2632-6140 – Name: NoteTitleSource Label: Relation Group: SrcInfo Data: https://openaccess.sgul.ac.uk/id/eprint/117284/1/e000918.full.pdf; https://openaccess.sgul.ac.uk/id/eprint/117284/3/inline-supplementary-material-1.pdf; Cabreira, V; Alty, J; Antic, S; Araujo, R; Aybek, S; Ball, HA; Baslet, G; Bhome, R; Coebergh, J; Dubois, B; et al. Cabreira, V; Alty, J; Antic, S; Araujo, R; Aybek, S; Ball, HA; Baslet, G; Bhome, R; Coebergh, J; Dubois, B; Edwards, M; Filipovic, SR; Frederiksen, KS; Harbo, T; Hayhow, B; Howard, R; Huntley, J; Isaacs, JD; Lafrance, C; Larner, A; Di Lorenzo, F; Main, J; Mallam, E; Marra, C; Massano, J; Mcgrath, ER; Portela Moreira, I; Nobili, F; Pal, S; Pennington, CM; Tabuas-Pereira, M; Perez, D; Popkirov, S; Rayment, D; Rossor, M; Russo, M; Santana, I; Schott, J; Scott, EP; Taipa, R; Teodoro, T; Tinazzi, M; Tomic, S; Toniolo, S; Torring, CW; Wilkinson, T; Zeidler, M; Frostholm, L; Mcwhirter, L; Stone, J; Carson, A (2025) Development of a diagnostic checklist to identify functional cognitive disorder versus other neurocognitive disorders. BMJ NEUROLOGY OPEN, 7 (1). e000918. ISSN 2632-6140 https://doi.org/10.1136/bmjno-2024-000918 SGUL Authors: Coebergh, Jan – Name: DOI Label: DOI Group: ID Data: 10.1136/bmjno-2024-000918 – Name: URL Label: Availability Group: URL Data: https://openaccess.sgul.ac.uk/id/eprint/117284/<br />https://openaccess.sgul.ac.uk/id/eprint/117284/1/e000918.full.pdf<br />https://doi.org/10.1136/bmjno-2024-000918 – Name: Copyright Label: Rights Group: Cpyrght Data: cc_by_nc_4 – Name: AN Label: Accession Number Group: ID Data: edsbas.8CC38BA5 |
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