P1‐077: Predictive value of the cognitive performance test (CPT) for staging function and fitness to drive
Bibliographic record
Abstract
91 Veterans diagnosed with cognitive impairment in specialty (n = 55) or primary (n = 36) care were administered a standardized occupational therapy performance measure, the Cognitive Performance Test (CPT), in conjunction with a driving exam. It includes seven subtasks for which the information-processing requirements are systematically varied to assess ordinal performance levels ranging from 5.6 (normal function) to 1. We report on the predictive value of CPT levels as applied to both diagnosis and driving. Value of the CPT and other cognitive measures (Large Allen Cognitive Level Screen (LACLS), Montreal Cognitive Assessment (MoCA), MMSE) were compared for predicting an on-road test of driving performance. Sensitivity and specificity were calculated for the outcome of driving retirement vs. driving restriction for early disease. We also studied the ability of CPT to correctly classify AD or another dementia versus MCI diagnosed by consensus. Subjects fell into four diagnostic groups including cognitive impairment/not demented (CIND; n = 9); mild cognitive impairment (n = 13); AD (n = 52); and non-AD Dementia (n = 17). Groups were compared on the clinical measures including CPT5, a five subtask battery, and CPT-Toast, a single task approach. Analysis of variance, followed by Bonferroni-adjusted pairwise group comparisons, was used. Below 4.7, CPT sensitivity for driving retirement was 89% with specificity for restricted driving at 75%. For CPT5, 4.7 yielded 92% sensitivity and 63% specificity. For CPT-Toast, sensitivity was poor at 23%. The four diagnostic groups differed on CPT(P <0.001), CPT5(P <0.001), and MoCA(P = 0.048). Groups were not significantly different on MMSE(P = 0.062), LACLS(P = 0.123) or CPT-Toast(P = 0.114). For CPT, post-hoc comparisons revealed that the CIND group was significantly different from AD (P <0.001), and from dementia (P = 0.003), but not from MCI (P = 0.765). The AD group was significantly different from MCI (P <0.001), but not from dementia (P = 0.669). The MCI group was significantly different from the dementia group (P = 0.003). The pattern of group differences was identical for CPT5. None of the two-group posthoc comparisons for MoCA had P <0.05 following Bonferroni correction for multiple comparisons. The CPT provides a reliable measure of functional level and fitness to drive; other clinical measures had less predictive value. CPT also correlated better with concensus diagnosis of cognitive impairment than did other measures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".