A systematic review of the screening accuracy of the HIV Dementia Scale and International HIV Dementia Scale.

<h4>Background</h4>The HIV Dementia Scale (HDS) and International HIV Dementia Scale (IHDS) are brief tools that have been developed to screen for and aid diagnosis of HIV-associated dementia (HAD). They are increasingly being used in clinical practice for minor neurocognitive disorder (...

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Autores principales:	Lewis John Haddow, Sian Floyd, Andrew Copas, Richard John Cary Gilson
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e21243c19ea34907ac4b761db307e7c7
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spelling	oai:doaj.org-article:e21243c19ea34907ac4b761db307e7c72021-11-18T07:49:15ZA systematic review of the screening accuracy of the HIV Dementia Scale and International HIV Dementia Scale.1932-620310.1371/journal.pone.0061826https://doaj.org/article/e21243c19ea34907ac4b761db307e7c72013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23613945/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The HIV Dementia Scale (HDS) and International HIV Dementia Scale (IHDS) are brief tools that have been developed to screen for and aid diagnosis of HIV-associated dementia (HAD). They are increasingly being used in clinical practice for minor neurocognitive disorder (MND) as well as HAD, despite uncertainty about their accuracy.<h4>Methods and findings</h4>A systematic review of the accuracy of the HDS and IHDS was conducted. Studies were assessed on Standards for Reporting Diagnostic Accuracy criteria. Pooled sensitivity, specificity, likelihood ratios (LR) and diagnostic odds ratios (DOR) were calculated for each scale as a test for HAD or MND. We retrieved 15 studies of the HDS, 10 of the IHDS, and 1 of both scales. Thirteen studies of the HDS were conducted in North America, and 7 of the IHDS studies were conducted in sub-Saharan Africa. Estimates of accuracy were highly heterogeneous between studies for the HDS but less so for the IHDS. Pooled DOR for the HDS was 7.52 (95% confidence interval 3.75-15.11), sensitivity and specificity for HAD were estimated at 68.1% and 77.9%, and sensitivity and specificity for MND were estimated at 42.0% and 91.2%. Pooled DOR for the IHDS was 3.49 (2.12-5.73), sensitivity and specificity for HAD were 74.3% and 54.7%, and sensitivity and specificity for MND were 64.3% and 66.0%.<h4>Conclusion</h4>Both scales were low in accuracy. The literature is limited by the lack of a gold standard, and variation in estimates of accuracy is likely to be due to differences in reference standard. There is a lack of studies comparing both scales, and they have been studied in different populations, but the IHDS may be less specific than the HDS. These rapid tests are not recommended for diagnostic use, and further research is required to inform their use in asymptomatic screening.Lewis John HaddowSian FloydAndrew CopasRichard John Cary GilsonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 4, p e61826 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lewis John Haddow Sian Floyd Andrew Copas Richard John Cary Gilson A systematic review of the screening accuracy of the HIV Dementia Scale and International HIV Dementia Scale.
description	<h4>Background</h4>The HIV Dementia Scale (HDS) and International HIV Dementia Scale (IHDS) are brief tools that have been developed to screen for and aid diagnosis of HIV-associated dementia (HAD). They are increasingly being used in clinical practice for minor neurocognitive disorder (MND) as well as HAD, despite uncertainty about their accuracy.<h4>Methods and findings</h4>A systematic review of the accuracy of the HDS and IHDS was conducted. Studies were assessed on Standards for Reporting Diagnostic Accuracy criteria. Pooled sensitivity, specificity, likelihood ratios (LR) and diagnostic odds ratios (DOR) were calculated for each scale as a test for HAD or MND. We retrieved 15 studies of the HDS, 10 of the IHDS, and 1 of both scales. Thirteen studies of the HDS were conducted in North America, and 7 of the IHDS studies were conducted in sub-Saharan Africa. Estimates of accuracy were highly heterogeneous between studies for the HDS but less so for the IHDS. Pooled DOR for the HDS was 7.52 (95% confidence interval 3.75-15.11), sensitivity and specificity for HAD were estimated at 68.1% and 77.9%, and sensitivity and specificity for MND were estimated at 42.0% and 91.2%. Pooled DOR for the IHDS was 3.49 (2.12-5.73), sensitivity and specificity for HAD were 74.3% and 54.7%, and sensitivity and specificity for MND were 64.3% and 66.0%.<h4>Conclusion</h4>Both scales were low in accuracy. The literature is limited by the lack of a gold standard, and variation in estimates of accuracy is likely to be due to differences in reference standard. There is a lack of studies comparing both scales, and they have been studied in different populations, but the IHDS may be less specific than the HDS. These rapid tests are not recommended for diagnostic use, and further research is required to inform their use in asymptomatic screening.
format	article
author	Lewis John Haddow Sian Floyd Andrew Copas Richard John Cary Gilson
author_facet	Lewis John Haddow Sian Floyd Andrew Copas Richard John Cary Gilson
author_sort	Lewis John Haddow
title	A systematic review of the screening accuracy of the HIV Dementia Scale and International HIV Dementia Scale.
title_short	A systematic review of the screening accuracy of the HIV Dementia Scale and International HIV Dementia Scale.
title_full	A systematic review of the screening accuracy of the HIV Dementia Scale and International HIV Dementia Scale.
title_fullStr	A systematic review of the screening accuracy of the HIV Dementia Scale and International HIV Dementia Scale.
title_full_unstemmed	A systematic review of the screening accuracy of the HIV Dementia Scale and International HIV Dementia Scale.
title_sort	systematic review of the screening accuracy of the hiv dementia scale and international hiv dementia scale.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/e21243c19ea34907ac4b761db307e7c7
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A systematic review of the screening accuracy of the HIV Dementia Scale and International HIV Dementia Scale.

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