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Proposing the short Neurological Evaluation Scale

Published online by Cambridge University Press:  24 October 2016

Akin Ojagbemi ,
Robin Emsley  and
Oye Gureje
Akin Ojagbemi*
Affiliation:
World Health Organization (WHO) Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, University of Ibadan, Ibadan, Oyo State, Nigeria
Robin Emsley
Affiliation:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
Oye Gureje
Affiliation:
World Health Organization (WHO) Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, University of Ibadan, Ibadan, Oyo State, Nigeria
*
Akin Ojagbemi, Department of Psychiatry, University of Ibadan, Cape Town, Western Cape,Nigeria. Tel: +234 803 673 7171; E-mail: [email protected]
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Abstract

Objectives

The time required in completing the 26 items of neurological examinations in the standard Neurological Evaluation Scale (NES) may limit its utility in pragmatic clinical situations. We propose the Short Neurological Evaluation Scale (S-NES) for use in busy clinical settings, and in research.

Methods

Using confirmatory factor analyses, we identified 12 items of neurological examination showing significant overlap with previously reported theoretical and empirical categories of neurological soft signs (NSS) in schizophrenia. This provided justification for the development of a shorter version of the NES based on the empirically identified NSS. In the present study, we relied on existing data to present an initial validation of the S-NES against the referent standard 26-item NES. We determined sensitivity, specificity, and likelihood ratios. Posterior-test probability was estimated using a Bayesian nomogram plot.

Results

Using data derived from 84 unmedicated or minimally treated patients with first-episode schizophrenia, 12 empirically determined items of neurological examinations showed high agreement with the 26 items in the standard NES battery (sensitivity=96.3%, specificity=100%, and posterior-test probability=100%).

Conclusions

Within limitations of validity estimates derived from existing data, the present results suggest that the design of the S-NES based on empirically identified 12 items of neurological examination is a logical step. If successful, the S-NES will be useful for rapid screening of NSS in busy clinical settings, and also in research.

Keywords

biological markersendophenotypespsychometric analysesscreening tools
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 29 , Issue 4 , August 2017 , pp. 236 - 243
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Copyright
© Scandinavian College of Neuropsychopharmacology 2016 

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