Published eLetters
If you would like to comment on this article, click on Submit a Response to This article, below. We welcome your input.
Jump to comment:
- Page navigation anchor for RE: Clock-Drawing Test as a Screening Tool for Cognitive Impairment Associated with Fecal Immunochemical Test Collection ErrorsRE: Clock-Drawing Test as a Screening Tool for Cognitive Impairment Associated with Fecal Immunochemical Test Collection Errors
The FIT instructions for our study were duplicative of the instructions each manufacturer provides to the public. We didn't alter those instructions. We wanted the study to be the same as how a patient would normally collect their specimen. Our study invited persons having a colonoscopy. We did not have anything to do with the preparation or the procedure. We reviewed the colonoscopy report after it was completed. It would be good to conduct a similar study in a different population.
Thanks for your comments.
Sincerely,
Jeanette DalyCompeting Interests: None declared. - Page navigation anchor for RE: Clock-Drawing Test as a Screening Tool for Cognitive Impairment Associated With Fecal Immunochemical Test Collection ErrorsRE: Clock-Drawing Test as a Screening Tool for Cognitive Impairment Associated With Fecal Immunochemical Test Collection Errors
We are three aspiring healthcare professionals currently studying at The Ohio State University.
As colon cancer remains one of the leading causes of death in the United States, we are aware of the importance of early screening and detection. After reading your article, a few things stood out to us. First, the number of rejected samples, due to collection errors, was higher than we expected. And, as such, we are curious as to the underlying reasons for this occurrence. Given that previous research has documented difficulty of internet-based colonoscopy preparation information,1 we wonder if fecal immunochemical test (FIT) instructions provided in your study had been assessed for readability and/or created in accordance with Plain Writing Act—2010 guidelines?2 Further, did participants have an opportunity to ask questions about FIT instructions? Second, as study participants were also taking laxatives, we are curious as to whether you assessed correct dosing and administration for laxatives as well. Third, the study population consisted predominantly of highly educated adults (72% had at least a college degree). As such, we wonder what the results would look like if the study sample more accurately represented the American population regarding educational attainment. Thank you for considering our questions.References
1. MacLean SA, Basch CH, Clark A, Basch CE. Readability of information on colonoscopy preparation on the internet. Health Promot...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: Clock-Drawing Test as a Screening Tool for Cognitive Impairment Associated with Fecal Immunochemical Test Collection ErrorsRE: Clock-Drawing Test as a Screening Tool for Cognitive Impairment Associated with Fecal Immunochemical Test Collection Errors
Clock Drawing Test: One method of knowing the informant
Show More
Originally the Clock Drawing Test (CDT) was used to assess constructional apraxia and employed in investigations of soldiers who were victims of head trauma during World War II.1 In 1986, Shulman and colleagues published the first study using the CDT as a screening tool for older adults with possible cognitive disorders.2 CDT allows for simultaneous evaluation of different cognitive abilities, including attention, comprehension, verbal working memory, numerical knowledge, visual memory and reconstruction, visuospatial skills, praxis and executive function. 3 Since 1986 there has been at least 25 CDT scoring systems develop, yet no consensus reached on which scoring method is the most accurate.1,4 When screening for dementia, CDTs are reported to be 67% to 98% sensitive and 69% to 95% specific.5
Daly et al6 used the CDT, scored with the Mendes-Santos4 and the Watson7 methods, to evaluate for cognitive impairment in a sample of 1448 participants without a history of dementia and a mean age of 63 years. Their hypothesis was that impairment demonstrated on the CDT may be associated with errors in fecal immunochemical test (FIT) sample collection. They found that being female, having 8th grade education or less, and having an abnormal clock drawing scored by Mendes-Santo’s method were associated with FIT collection errors.
Daly’s study raises an important issue for primary care physicians, as they may re...Competing Interests: None declared.