Research article

Diagnostic accuracy of the Eurotest for dementia: a naturalistic, multicenter phase II study

Cristobal Carnero-Pardo¹ , Manuel Gurpegui² , Emilio Sanchez-Cantalejo³ , Ana Frank⁴ , Santiago Mola⁵ , M Sagrario Barquero⁶ and M Teresa Montoro-Rios¹ for The Trans-EUROTEST Group

¹  Hospital Universitario Virgen de las Nieves, Granada, Spain

²  Department of Psychiatry and Institute of Neurosciences, Universidad de Granada, Spain

³  Escuela Andaluza de Salud Pública, Granada, Spain

⁴  Hospital Universitario La Paz, Madrid, Spain

⁵  Hospital Vega Baja, Orihuela, Alicante, Spain

⁶  Hospital Clínico San Carlos, Madrid, Spain

author email corresponding author email

BMC Neurology 2006, 6:15doi:10.1186/1471-2377-6-15

Published:	10 April 2006

Abstract

Background

Available screening tests for dementia are of limited usefulness because they are influenced by the patient's culture and educational level. The Eurotest, an instrument based on the knowledge and handling of money, was designed to overcome these limitations. The objective of this study was to evaluate the diagnostic accuracy of the Eurotest in identifying dementia in customary clinical practice.

Methods

A cross-sectional, multi-center, naturalistic phase II study was conducted. The Eurotest was administered to consecutive patients, older than 60 years, in general neurology clinics. The patients' condition was classified as dementia or no dementia according to DSM-IV diagnostic criteria. We calculated sensitivity (Sn), specificity (Sp) and area under the ROC curves (aROC) with 95% confidence intervals. The influence of social and educational factors on scores was evaluated with multiple linear regression analysis, and the influence of these factors on diagnostic accuracy was evaluated with logistic regression.

Results

Sixteen neurologists recruited a total of 516 participants: 101 with dementia, 380 without dementia, and 35 who were excluded. Of the 481 participants who took the Eurotest, 38.7% were totally or functionally illiterate and 45.5% had received no formal education. Mean time needed to administer the test was 8.2+/-2.0 minutes. The best cut-off point was 20/21, with Sn = 0.91 (0.84–0.96), Sp = 0.82 (0.77–0.85), and aROC = 0.93 (0.91–0.95). Neither the scores on the Eurotest nor its diagnostic accuracy were influenced by social or educational factors.

Conclusion

This naturalistic and pragmatic study shows that the Eurotest is a rapid, simple and useful screening instrument, which is free from educational influences, and has appropriate internal and external validity.