The Northwick Park Examination of Cognition: A brief cognitive assessment tool for use in acute stroke services
Bibliographic record
Abstract
Background/Aims: Assessment of cognitive impairment following stroke forms an important part of diagnosis, treatment and rehabilitation planning. However, none of the available and widely used tools were developed specifically for use in stroke services. Most screening tools were developed for dementia, and consequently are biased toward an evaluation of memory function, provide inadequate assessment of executive function and are mainly verbally administered, limiting their utility in aphasic patients. Methods: One hundred and sixty-six stroke patients admitted to a hyper acute stroke unit and a control sample of 100 healthy participants completed the Northwick Park Examination of Cognition (NPEC). The NPEC includes 22 sub-tests in the domains of reasoning, episodic memory, language, perception and attention/executive function. Multiple input (verbal, visual) and output (spoken, written, gesture) modalities increase accessibility to patients with various deficits/lesion locations. Findings: Mean time from stroke to assessment was 5.6 days (SD=7.9). Seventy five percent of patients gained impaired scores (mild, moderate or severe impairment), which was evident at the group level on all subtests. Left and right cortical stroke patients differed significantly (P<0.05) on specific verbal (R>L) and spatial attention (L>R) subtests. Sensitivity and specificity for the detection of cognitive impairment (sensitivity=0.90; specificity=0.80; area-under-curve [AUC]=0.93) were equivalent or superior to data reported for established cognitive screening tools (AUC=0.53–0.89). Patients were disproportionately impaired on high vs low attentional demand cancellation tasks (P<0.0001). Conclusions: The NPEC is brief, freely available and has good sensitivity and specificity for differentiating stroke patients from controls in terms of cognitive functioning. The inclusion of timed executive function measures and comparable verbal and non-verbal sub-tests permits characterisation of cognitive dysfunction in different stroke subtypes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".