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The Neurobehavioral Cognitive Status Examination: Comparison with the Cognitive Capacity Screening Examination and the Mini-Mental State Examination in a Neurosurgical Population

LEE H. SCHWAMM, B.A.; CRAIG VAN DYKE, M.D.; RALPH J. KIERNAN, Ph.D.; EDWARD L. MERRIN, M.D.; and JONATHAN MUELLER, M.D.
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▸Requests for reprints should be addressed to Jonathan Mueller, M.D.; San Francisco Veterans Administration Medical Center (116N), 4150 Clement Street; San Francisco, CA 94121.


San Francisco, California


©1987 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1987;107(4):486-491. doi:10.7326/0003-4819-107-4-486
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Studies to determine the validity of the Mini-Mental State Examination (MMSE) and the Cognitive Capacity Screening Examination (CCSE) have indicated unacceptably high false-negative rates for these tests. To determine whether a new examination, the Neurobehavioral Cognitive Status Examination (NCSE), is more sensitive in the detection of cognitive dysfunction, we compared the three examinations in 30 patients with documented brain lesions. The CCSE had a false-negative rate of 53%; the MMSE, of 43%; and the NCSE, of 7%. The sensitivity of the NCSE is derived from two features of its design: the use of independent tests to assess skills within five major areas of cognitive functioning, and the use of graded tasks within each of these cognitive domains.

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