Supplementary Material for: Adaption and validation of the Greek version of Addenbrooke's Cognitive Examination III scale as a screening tool for perioperative cognitive impairment detection
Bibliographic record
Abstract
Introduction: Postoperative cognitive dysfunction constitutes an extremely prevalent implication in individuals subjected to cardiac or non-cardiac surgery. This study aims to assess the validity and reliability of a culturally adapted Greek version of the Addenbrooke’s Cognitive Examination III (ACE-III) scale as a screening tool for perioperative neurocognitive status determination in elderly surgical patients. Methods: A cross-cultural adaptation and validation of instruments throughout the a cross-sectional study was conducted. The study sample consisted of 128 individuals over 55 years old scheduled for surgical intervention. All participants were screened twice; at the preadmission clinic and the day before surgery using the already established MoCA scale and the culturally adapted Greek version of the ACE-III scale. Subjects with a MoCA score of < 26 constituted the cognitively impaired group. Results: Regarding construct validity, ACE-III’s performance in detecting cognitive impairment was excellent (AUC =0.942; 95%CI 0.899-0.971). Convergent validity between ACE-III and MoCA scales was excellent (r= 0.876; 95%CI 0.839-0.905). Known group validity was confirmed since advanced age and lower educational attainment adversely impacted ACE-III’s total score (p<0.001). Additionally, specialists suggested face validity (mean 8.7 out of 10, SD 1.1). In terms of reliability, ACE-III demonstrated good internal consistency (Cronbach's alpha 0.786) and high inter-rater (ICC=0.936 [95%CI 0.921-0.941]) and test-retest reliability (ICC=0.972 (95%CI 0.958-0.981). Conclusion: The Greek version of ACE-III is a valid, and reliable screening tool that could be routinely employed perioperatively as a valid alternative to the MoCA test to distinguish the mild cognitively impaired from healthy elderly candidates for surgical interventions.
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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 | 0.003 | 0.038 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| 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) | 0.669 | 0.188 |
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".