22 How does the free cog compare to the Addenbrooke’s cognitive examination (ACE III) in traumatic brain injury (TBI)?
Bibliographic record
Abstract
Objectives Cognitive dysfunction is the most frequent sequalae post TBI1with a prevalence of 25–70%2and has been implicated in poorer patient outcomes such as greater difficulties in employment, maintaining relationships, pursuing leisure activities and quality of life,3with impairments in attention, concentration, memory, language, executive functions and reduced speed of information processing.4Brief screening instruments may not identify frontal lobe disorders with impairments in executive and social function. Here we looked at the Free-Cog, a novel, hybrid, cognitive screening instrument that assess both cognitive and executive function in a single instrument5and comparing it to a known standard, the ACE III. Methods A cohort of 10 males with moderate to severe TBI admitted in a neuropsychiatry unit between 2021 and 2022 were assessed with both an ACE III and the Free Cog. Results Patients varied in age (20–71), TBI site and of differing chronicity. Z scores were calculated using published normative data. Spearman’s rho showed positive correlation between the two data sets (Correlation Coefficient 0.81818, p(2-tailed) = 0.00381). Therefore, there was a statistically significant agreement between the subjective total Free Cog scores and the ACE III. Conclusions These findings indicate that the Free Cog may be a useful brief screening in TBI patients and is consistent with the Free-Cog index study which showed high correlation and similar diagnostic accuracy in old age memory clinics where it was compared with Mini Mental Screening Examination, Montreal Cognitive Assessment and the ACE-III.6These preliminary findings indicate further assessment of the Free Cog is warranted with examination of outcomes in different domains and in a wider range of TBI severity. References McAllister TW. Neurobehavioral sequelae of traumatic brain injury: evaluation and management.World Psychiatry2008;7(1):3–10. Vaishnavi S, Rao V, Fann JR. Neuropsychiatric problems after traumatic brain injury: unraveling the silent epidemic.Psychosomatics2009;50(3):198–205. Zhang J, Feinstein A. Screening for cognitive impairments after traumatic brain injury: a comparison of a brief computerized battery with the montreal cognitive assessment.J Neuropsychiatry Clin Neurosci.2016;28:328–331; doi: 10.1176/appi.neuropsych.16010005 Rao V, Lyketsos C. Neuropsychiatric sequelae of traumatic brain injury.Psychosomatics2000;41(2):95–103. Review. Burns A, Larner AJ. Do we need yet another cognitive test? Free-Cog, a novel, hybrid, cognitive screening instrument.J Neurol Neurosurg Psychiatry2021;92:1359–1360. Burns A, Harrison JR, Symonds C,et al. A novel hybrid scale for the assessment of cognitive and executive function: the Free-Cog.Int J Geriatr Psychiatry2020;14.
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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 | 0.009 | 0.036 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.005 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".