Article Figures & Data
Figures
- Figure 1.
Examples of abnormal clock drawings.
Tables
Mendes-Santos Methodb,22 Original Scoring Adaptations to Directions and Scoring (Item) Description
(a) Presence of a circle
(b) Presence of 12 numbers
(c) Numbers entered in the internal limit of the clock
(d) Number in the correct ascending order
(e) Numbers in correct spatial position
(f) A straight vertical line can be drawn between 12 and 6
(g) A straight horizontal line can be drawn between 3 and 9
(h) Numbers not concentrated in 1 part of the clock
(i) Presence of 2 points
(j) Presence of hour hand
(k) Presence of minute hand
(l) Minute hand proportionally larger than the hour hand
(m) One of the hands between 2 and 3
(n) One of the hands on exactly 9
(o) Wrong use of hands (digital or circling the numbers)
(p) Some evidence of having understood that it is a clock
(q) Did not try or did not represent a clock(Score) Explanation
Mark all the items present in the drawn clock with an “X”.a
(10) Correct time (no mark for items o, p, q)
(9) Very mild disorder of hands (no mark for at least one item of l, m, n)
(8) Mild disorder of hands (no mark for at least 2 items of l, m, n)
(7) Severe disorder of hands (no mark for items l, m, n)
(6) Wrong use of hands (item o is marked)
(5) Numbers in reverse order or concentrated (no mark for items d or h)
(4) Numbers missing or located outside the boundary of the clock (no mark for items b and c)
(3) Absence of hands (no mark for items i, j, k)
(2) Only some evidence of having understood that it is a clock (item p is marked)
(1) Not tried or did not represent a clock (item q is marked)
If the item o is checked, the score is 6 points.
If the item p is checked, the score is 2 points.
If the item q is checked, the score is 1 point.Patients were asked to signify the time as 10 minutes after 11.
Item m was adapted to say, “on exactly 2.”
Item n was adapted to say, “on exactly 11.”
Four numbers with intervening tick marks were accepted as presence of 12 numbers.Watson Methodc,17 Original Scoring Adaptations to Directions and Scoring Instructions to patients
Divide circle into 4 quadrants drawing a line through the center of the circle and the number 12.
Draw the second line perpendicular to and bisecting the first line.
Count each digit with the number 12 being in the top right quadrant.
Count numbers in the clockwise direction.
If a number fell on 1 of the lines, it was counted in the quadrant clockwise from the line.Scoring explanations
If a clock were drawn correctly, the numbers 12, 1, and 2 would be in the first quadrant, 3, 4, and 5 in the second quadrant, and so on.
Any error in the first 3 quadrants was a score of 1 and any error in the last quadrant (numbers 9, 10, and 11) was a score of 4.
If no errors were made, the final score was a 0.Instructions in the mailing did not specify that patients must include “all” numbers.
Clocks with 4 numbers (12, 3, 6, 9) in the correct spatial position were scored as 0.
Four numbers (12, 3, 6, 9) with intervening tick marks were accepted as presence of twelve numbers and scored as 0.
If clocks had the numbers 12, 3, 6, and 9 along with the numbers 2 and 11 to signify the time, those clocks were scored as 0.↵a Each method had a pre-drawn circle on the questionnaire.
↵b Score could range from 1-10 with 10 as the best possible score. Scores of 6-10 were considered normal and scores of 1-5 abnormal.
↵c Scores could range from 0-7 with 0 as the best possible score. Scores of 0-3 were considered normal and scores of 4-7 abnormal.
Characteristic No. (%) Age, y <65 882 (60.9) 65-75 466 (32.2) >75 100 (6.9) Sex Female 908 (62.7) Male 540 (37.3) Race Black 94 (6.5) White 1,201 (82.9) Other 153 (10.6) Ethnicity Hispanic 354 (24.4) Non-Hispanic 1,083 (74.8) Unknown 11 (0.8) Education ≤8th grade 75 (5.2) High School/GED 324 (22.6) College or higher 1,035 (72.2) Income, $ <40,000 491 (33.9) 40,000-80,000 329 (22.7) >80,000 573 (39.6) Not reported 55 (3.8) GED = general equivalency diploma.
Characteristic Watson Method Score17 Mendes-Santos Method Score22 Normal, No. (%) Abnormal, No. (%) P Valuea Normal, No. (%) Abnormal, No. (%) P Valuea Total 1,070 (73.9) 378 (26.1) 1,156 (79.8) 292 (20.2) Age, y .039 .017 <65 672 (76.2) 210 (23.8) 725 (82.2) 157 (17.8) 65-75 330 (70.8) 136 (29.2) 357 (76.6) 109 (23.4) >75 68 (68.0) 32 (32.0) 74 (74.0) 26 (26.0) Sex <.001 <.001 Female 709 (78.1) 199 (21.9) 770 (84.8) 138 (15.2) Male 361 (66.9) 179 (33.2) 386 (71.5) 154 (28.5) Race .026 .273 Black 61 (64.9) 33 (35.1) 72 (76.6) 22 (23.4) White 886 (73.8) 315 (26.2) 955 (79.5) 246 (20.5) Other 123 (80.4) 30 (19.6) 129 (84.3) 24 (15.7) Ethnicity .006 <.001 Hispanic 284 (80.2) 70 (19.8) 310 (87.6) 44 (12.4) Non-Hispanic 777 (71.8) 306 (28.3) 836 (77.2) 247 (22.8) Unknown 9 (81.8) 2 (18.2) 10 (90.9) 1 (9.1) Education .349 .147 ≤8th grade 53 (70.7) 22 (29.3) 65 (86.7) 10 (13.3) High School/GED 249 (76.9) 75 (23.2) 265 (81.8) 59 (18.2) College or higher 758 (73.2) 277 (26.8) 814 (78.7) 221 (21.4) Income, $ .002 <.001 <40,000 412 (83.9) 79 (16.1) 439 (89.4) 52 (10.6) 40,000-80,000 271 (82.4) 58 (17.6) 281 (85.4) 48 (14.6) >80,000 432 (75.4) 141 (24.6) 444 (77.5) 129 (22.5) Not reported 40 (72.7) 15 (27.3) 43 (78.2) 12 (21.8) GED = general equivalency diploma.
↵a χ2 test
- Table 4.
Generalized Linear Mixed Model of Factors Associated With Errors in FIT Collection (N = 1,448)
Factors FIT Collection Errors (Yes) No. (%) Univariable Model Multivariable Model Odds Ratio (95% CI) P Values Odds Ratio (95% CI) P Values Age, y <65 97 (11.0) 0.61 (0.34-1.12) .109 0.61 (0.34-1.11) .107 65-75 41 (8.8) 0.51 (0.27-0.97) .040 0.48 (0.25-0.91) .026 >75 15 (15.0) Reference Reference Sex Female 108 (11.9) 1.43 (0.99-2.07) .056 1.49 (1.02-2.19) .039 Male 45 (8.3) Reference Reference Race White 118 (9.8) 0.61 (0.32-1.14) .123 Others 22 (14.4) 0.79 (0.36-1.73) .558 Black 13 (13.8) Reference Ethnicity Hispanic 51 (14.4) 1.64 (1.14-2.35) .007 Non-Hispanic 102 (9.3) Reference Education ≤8th grade 20 (26.7) 3.68 (2.12-6.42) <.001 3.76 (2.14-6.62) <.001 High School/GED 38 (11.7) 1.35 (0.90-2.01) .146 1.38 (0.92-2.06) College or higher 93 (9.0) Reference Reference .120 Watson Method Score17 Abnormal 47 (12.4) 1.34 (0.93-1.94) .118 Normal 106 (9.9) Reference Mendes-Santos Method Score22 Abnormal 38 (13.0) 1.44 (0.97-2.13) .073 1.57 (1.05-2.36) .029 Normal 115 (10.0) Reference Reference FIT = fecal immunochemical test; GED = general equivalency diploma.
SUPPLEMENTAL DATA IN PDF FILE BELOW
Supplemental Appendix 1. Methods for the Comparative Effectiveness Study to Test Characteristics of 5 FITs With colonoscopy
