193Rates of Refusal of Cognitive Screening Tests in Older Medical Inpatients
Bibliographic record
Abstract
Routine cognitive screening in older medical inpatients is important to facilitate detection of delirium, a medical emergency. There is little data pertaining to the feasibility of routine screening in hospitalised patients. One factor impacting test feasibility is rate of patient refusal. This study aimed to identify refusal rates for five short cognitive tests in older medical inpatients. As part of a study of delirium in older medical inpatients, participants were assessed within 36 hours of presentation using five short cognitive tests: Six-item Cognitive Impairment Test (6-CIT), Months of the Year Backwards (MOTYB), Spatial Span Forwards (SSF), Clock-Drawing Test (CDT), and Intersecting Pentagons Test (IPT). Participants were also assessed for delirium using the Revised Delirium Rating Scale. Dementia status was determined using the Informant Questionnaire for Cognitive Decline in the Elderly- Short Form. Refusal to participate in testing was documented and refusal rates for each test were calculated for the whole group and for neurocognitive subgroups (delirium, dementia without delirium, no neurocognitive disorder). Of 470 participants, the median age was 81 years, and 50.4% (n = 237) were female. The most commonly refused test overall was CDT (n = 111 refused, 23.6%), followed by IPT (n = 82 refused, 17.4%). MOTYB (n = 30 refused, 6.4%) had the lowest refusal rate. Patients with delirium had higher refusal rates for all tests, although MOTYB was still the least refused (n = 28 refused, 15.2%). Patients with dementia (without delirium) and normal controls had similar completion rates for all tests. When choosing a cognitive screening test in the acute setting, it is important to consider acceptability to patients. Delirium detection is often the purpose of such testing, hence the ability to conduct the test in delirious patients is key. MOTYB may have utility for this purpose, given its higher rates of completion among all neurocognitive subgroups.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.005 | 0.033 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| 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".