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Statistical assessment of MMSE scores

Published online by Cambridge University Press:  02 January 2018

Alastair Willis*
Affiliation:
Wāhi Oranga, Nelson Hospital, Private Bag 18, Whakatū 7001, New Zealand, e-mail: [email protected]
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Abstract

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Columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 2006. The Royal College of Psychiatrists

It is disappointing that the interesting study by O’Loughlin & Darley (Psychiatric Bulletin, April 2006, 30, 131–134) was let down by the use of inappropriate statistics. Since scores on the Mini-Mental State Examination (MMSE) constitute data that are ordinal in nature, it is not appropriate for the mean to be presented as a measure of central tendency. For the same reason, it is not appropriate for standard deviation to be offered as a measure of dispersion. Use of the median and interquartile range (IQR) would have been more appropriate. Similarly, use of the t-test as a test for difference between the two groups was ill considered because MMSE scores in both study populations are negatively skewed. The authors should have used a non-parametric test for difference such as the Mann–Whitney U-test.

For the record, the median MMSE score was 20 (IQR 16–24) in the 1996 sample and 22 (IQR 19–25) in the 2003 sample. Running the authors’ data through a Mann–Whitney test on Stat Crunch (available at http://www.statcrunch.com) still finds a significant difference between the two groups (P=0.0037).

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