Methodology of measuring postoperative cognitive dysfunction: a systematic review
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Methodology of measuring postoperative cognitive dysfunction: a systematic review. / Borchers, Friedrich; Spies, Claudia D; Feinkohl, Insa; Brockhaus, Wolf-Rüdiger; Kraft, Antje; Kozma, Petra; Fislage, Marinus; Kühn, Simone; Ionescu, Catinca; Speidel, Saya; Hadzidiakos, Daniel; Veldhuijzen, Dieuwke S; Yürek, Fatima; Evered, Lisbeth A; Ottens, Thomas H.
in: BRIT J ANAESTH, Jahrgang 126, Nr. 6, 06.2021, S. 1119-1127.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Methodology of measuring postoperative cognitive dysfunction: a systematic review
AU - Borchers, Friedrich
AU - Spies, Claudia D
AU - Feinkohl, Insa
AU - Brockhaus, Wolf-Rüdiger
AU - Kraft, Antje
AU - Kozma, Petra
AU - Fislage, Marinus
AU - Kühn, Simone
AU - Ionescu, Catinca
AU - Speidel, Saya
AU - Hadzidiakos, Daniel
AU - Veldhuijzen, Dieuwke S
AU - Yürek, Fatima
AU - Evered, Lisbeth A
AU - Ottens, Thomas H
N1 - Copyright © 2021 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - BACKGROUND: Postoperative cognitive dysfunction (POCD) is an adverse outcome that impacts patients' quality of life. Its diagnosis relies on formal cognitive testing performed before and after surgery. The substantial heterogeneity in methodology limits comparability and meta-analysis of studies. This systematic review critically appraises the methodology of studies on POCD published since the 1995 Consensus Statement and aims to provide guidance to future authors by providing recommendations that may improve comparability between future studies.METHODS: This systematic review of literature published between 1995 and 2019 included studies that used baseline cognitive testing and a structured cognitive test battery, and had a minimal follow-up of 1 month. For cohorts with multiple publications, data from the primary publication were supplemented with available data from later follow-up studies.RESULTS: A total of 274 unique studies were included in the analysis. In the included studies, 259 different cognitive tests were used. Studies varied considerably in timing of assessment, follow-up duration, definition of POCD, and use of control groups. Of the 274 included studies, 70 reported POCD as a dichotomous outcome at 1 to <3 months, with a pooled incidence of 2998/10 335 patients (29.0%).CONCLUSIONS: We found an overwhelming heterogeneity in methodology used to study POCD since the publication of the 1995 Consensus Statement. Future authors could improve study quality and comparability through optimal timing of assessment, the use of commonly used cognitive tests including the Consensus Statement 'core battery', application of appropriate cut-offs and diagnostic rules, and detailed reporting of the methods used.PROSPERO REGISTRY NUMBER: CRD42016039293.
AB - BACKGROUND: Postoperative cognitive dysfunction (POCD) is an adverse outcome that impacts patients' quality of life. Its diagnosis relies on formal cognitive testing performed before and after surgery. The substantial heterogeneity in methodology limits comparability and meta-analysis of studies. This systematic review critically appraises the methodology of studies on POCD published since the 1995 Consensus Statement and aims to provide guidance to future authors by providing recommendations that may improve comparability between future studies.METHODS: This systematic review of literature published between 1995 and 2019 included studies that used baseline cognitive testing and a structured cognitive test battery, and had a minimal follow-up of 1 month. For cohorts with multiple publications, data from the primary publication were supplemented with available data from later follow-up studies.RESULTS: A total of 274 unique studies were included in the analysis. In the included studies, 259 different cognitive tests were used. Studies varied considerably in timing of assessment, follow-up duration, definition of POCD, and use of control groups. Of the 274 included studies, 70 reported POCD as a dichotomous outcome at 1 to <3 months, with a pooled incidence of 2998/10 335 patients (29.0%).CONCLUSIONS: We found an overwhelming heterogeneity in methodology used to study POCD since the publication of the 1995 Consensus Statement. Future authors could improve study quality and comparability through optimal timing of assessment, the use of commonly used cognitive tests including the Consensus Statement 'core battery', application of appropriate cut-offs and diagnostic rules, and detailed reporting of the methods used.PROSPERO REGISTRY NUMBER: CRD42016039293.
KW - Cognition
KW - Humans
KW - Neuropsychological Tests
KW - Postoperative Cognitive Complications/diagnosis
KW - Predictive Value of Tests
KW - Reproducibility of Results
KW - Research Design
KW - Time Factors
U2 - 10.1016/j.bja.2021.01.035
DO - 10.1016/j.bja.2021.01.035
M3 - SCORING: Review article
C2 - 33820655
VL - 126
SP - 1119
EP - 1127
JO - BRIT J ANAESTH
JF - BRIT J ANAESTH
SN - 0007-0912
IS - 6
ER -