array:24 [
  "pii" => "S225488741730070X"
  "issn" => "22548874"
  "doi" => "10.1016/j.rceng.2017.03.006"
  "estado" => "S300"
  "fechaPublicacion" => "2017-08-01"
  "aid" => "1391"
  "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Rev Clin Esp. 2017;217:320-4"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 3
    "formatos" => array:2 [
      "HTML" => 1
      "PDF" => 2
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0014256517301029"
      "issn" => "00142565"
      "doi" => "10.1016/j.rce.2017.03.004"
      "estado" => "S300"
      "fechaPublicacion" => "2017-08-01"
      "aid" => "1391"
      "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "sco"
      "cita" => "Rev Clin Esp. 2017;217:320-4"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 74
        "formatos" => array:2 [
          "HTML" => 38
          "PDF" => 36
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Breve</span>"
        "titulo" => "Valor diagn&#243;stico de un cuestionario de Pfeiffer simplificado en pacientes pluripatol&#243;gicos"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "320"
            "paginaFinal" => "324"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Diagnostic value of a simplified Pfeiffer questionnaire for polypathological patients"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1445
                "Ancho" => 2093
                "Tamanyo" => 185134
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Propuesta de abordaje pr&#225;ctico del cribado de deterioro cognitivo en pacientes pluripatol&#243;gicos&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46; Bernabeu-Wittel, D&#46; Nieto Mart&#237;n, L&#46; Moreno-Gavi&#241;o, M&#46; Ollero-Baturone"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Bernabeu-Wittel"
              ]
              1 => array:2 [
                "nombre" => "D&#46;"
                "apellidos" => "Nieto Mart&#237;n"
              ]
              2 => array:2 [
                "nombre" => "L&#46;"
                "apellidos" => "Moreno-Gavi&#241;o"
              ]
              3 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Ollero-Baturone"
              ]
              4 => array:1 [
                "colaborador" => "en representaci&#243;n de los investigadores del Proyecto Profund"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S225488741730070X"
          "doi" => "10.1016/j.rceng.2017.03.006"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225488741730070X?idApp=WRCEE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256517301029?idApp=WRCEE"
      "url" => "/00142565/0000021700000006/v1_201707280054/S0014256517301029/v1_201707280054/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S225488741730022X"
    "issn" => "22548874"
    "doi" => "10.1016/j.rceng.2017.03.002"
    "estado" => "S300"
    "fechaPublicacion" => "2017-08-01"
    "aid" => "1360"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Medicina Interna &#40;SEMI&#41;"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Rev Clin Esp. 2017;217:332-5"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2
      "PDF" => 2
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Special article</span>"
      "titulo" => "Why teaching empathy is important for the medical degree"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "332"
          "paginaFinal" => "335"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "&#191;Por qu&#233; es importante la ense&#241;anza de la empat&#237;a en el Grado de Medicina&#63;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "N&#46; D&#237;ez-Go&#241;i, M&#46;C&#46; Rodr&#237;guez-D&#237;ez"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "N&#46;"
              "apellidos" => "D&#237;ez-Go&#241;i"
            ]
            1 => array:2 [
              "nombre" => "M&#46;C&#46;"
              "apellidos" => "Rodr&#237;guez-D&#237;ez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0014256517300334"
        "doi" => "10.1016/j.rce.2017.01.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256517300334?idApp=WRCEE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225488741730022X?idApp=WRCEE"
    "url" => "/22548874/0000021700000006/v1_201707280038/S225488741730022X/v1_201707280038/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2254887417300693"
    "issn" => "22548874"
    "doi" => "10.1016/j.rceng.2017.03.005"
    "estado" => "S300"
    "fechaPublicacion" => "2017-08-01"
    "aid" => "1394"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Medicina Interna &#40;SEMI&#41;"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Rev Clin Esp. 2017;217:315-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 4
      "formatos" => array:2 [
        "HTML" => 3
        "PDF" => 1
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Brief Original</span>"
      "titulo" => "Use and dependence on opioid drugs in the Spanish population with chronic pain&#58; Prevalence and differences according to sex"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "315"
          "paginaFinal" => "319"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Uso y dependencia de f&#225;rmacos opioides en poblaci&#243;n espa&#241;ola con dolor cr&#243;nico&#58; prevalencia y diferencias de g&#233;nero"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; Coloma-Carmona, J&#46;L&#46; Carballo, J&#46; Rodr&#237;guez-Mar&#237;n, A&#46; P&#233;rez-Carbonell"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Coloma-Carmona"
            ]
            1 => array:2 [
              "nombre" => "J&#46;L&#46;"
              "apellidos" => "Carballo"
            ]
            2 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Rodr&#237;guez-Mar&#237;n"
            ]
            3 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "P&#233;rez-Carbonell"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0014256517301066"
        "doi" => "10.1016/j.rce.2017.03.007"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256517301066?idApp=WRCEE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417300693?idApp=WRCEE"
    "url" => "/22548874/0000021700000006/v1_201707280038/S2254887417300693/v1_201707280038/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Brief Original</span>"
    "titulo" => "Diagnostic value of a simplified Pfeiffer questionnaire for polypathological patients"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "320"
        "paginaFinal" => "324"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "M&#46; Bernabeu-Wittel, D&#46; Nieto Mart&#237;n, L&#46; Moreno-Gavi&#241;o, M&#46; Ollero-Baturone"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "M&#46;"
            "apellidos" => "Bernabeu-Wittel"
            "email" => array:1 [
              0 => "wittel&#64;cica&#46;es"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "D&#46;"
            "apellidos" => "Nieto Mart&#237;n"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "L&#46;"
            "apellidos" => "Moreno-Gavi&#241;o"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Ollero-Baturone"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:2 [
            "colaborador" => "on behalf of researchers from the Proyecto Profund"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#9674;</span>"
                "identificador" => "fn0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Unidad Cl&#237;nica de Medicina Interna&#44; Hospital Universitario Virgen del Roc&#237;o&#44; Sevilla&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Red de Investigaci&#243;n en Servicios de Salud en Enfermedades Cr&#243;nicas &#40;REDISSEC&#41;&#44; Instituto de Salud Carlos III&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Valor diagn&#243;stico de un cuestionario de Pfeiffer simplificado en pacientes pluripatol&#243;gicos"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1445
            "Ancho" => 2093
            "Tamanyo" => 179408
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Proposal for a practical approach for screening cognitive impairment in polypathological patients&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Cognitive impairment is common in polypathological patients&#44; both in the primary care and hospital settings&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#44;2</span></a> The prevalence of cognitive impairment in multicenter cohorts has been 37&#8211;39&#37;&#44; with a notably high percentage of patients with previously undetected occult cognitive impairment&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a> The risk of dementia for patients with mild cognitive impairment is known&#44; as is the case for polypathological patients&#46; Its early detection is therefore recommended&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;4</span></a> One of the most widely used questionnaires for screening dementia in those over 65 years of age is the Pfeiffer test &#40;Short Portable Mental State Questionnaire &#91;SPMSQ&#93;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> which has been validated in Spanish and shows generally good and diagnostically useful indices&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;7</span></a> The questionnaire is structured into 10 simple questions that explore various cognitive areas&#46; The estimated time for completing the questionnaire is 5&#8211;10<span class="elsevierStyleHsp" style=""></span>minutes&#46; A result with 3 or more errors &#40;4 or more in the case of illiteracy&#41; is highly suggestive of cognitive impairment&#44; using this cutoff operationally to indicate an in-depth study of dementia&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">It is useful to implement psychometric screening tests that easily enable the ruling out of the presence of cognitive deficit&#44; in such a way as to avoid the additional use of other&#44; more complex instruments&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Therefore&#44; we investigated the sensitivity &#40;S&#41;&#44; specificity &#40;Sp&#41;&#44; positive predictive value &#40;PPV&#41; and negative predictive value &#40;NPV&#41; for polypathological patients of each of the 10 questions in the SPMSQ&#44; as well as the possibility that 1 or 2 questions could be used as a screening for cognitive impairment&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">We conducted a cross-sectional study using the baseline data from a multicenter sample of 1632 polypathological patients included in the PROFUND project from 37 Spanish hospitals&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> This project recruited elderly hospitalized patients&#44; elderly patients in home hospitalization follow-up and elderly patients in outpatient internal medicine units or consultations&#44; after signing an informed consent document&#46; We collected clinical&#44; functional&#44; psychometric and healthcare parameters&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> The SPMSQ score was considered pathological if there were 3 or more errors &#40;4 or more in the case of illiteracy&#41;&#44; establishing this result as the gold standard for the presence or absence of cognitive impairment&#46; For each of the 10 questions&#44; we calculated the correlation using the kappa index&#44; S&#44; Sp&#44; PPV and NPV with respect to the gold standard&#46; We then analyzed whether the diagnostic validity indices improved through the use of combinations of 2 questions&#46; We employed the SPSS statistical package version 20&#46;0 for the calculations&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0020" class="elsevierStylePara elsevierViewall">Of the 1632 polypathological patients included &#40;mean age&#44; 77&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;8 years&#44; 53&#37; men&#41;&#44; 1434 performed the SPMSQ &#40;the remaining 198 presented active delirium through the Confusion Assessment Method at the time of the interview&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> The prevalence of cognitive impairment &#40;3 or more errors&#41; was 39&#37;&#44; which was distributed as mild-moderate in 28&#37; of the cases &#40;3&#8211;7 errors&#41; and severe in the remaining 11&#37; &#40;8 or more errors&#41;&#46; The median number of errors was 2 &#40;interquartile range&#44; 5&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the correlation and the diagnostic validity indices for each of the 10 questions and for the combinations of 2 questions with higher indices&#46; Question 1 &#40;&#8220;What is the date today &#91;day&#44; month year&#93;&#63;&#8221;&#41; and question 10 &#40;&#8220;Count backwards in threes from 20&#8221;&#41; were the 2 questions with highest NPV &#40;85&#37; and 89&#37;&#44; respectively&#41; and had good correlation with respect to the full questionnaire&#46; The combination of the 2 questions maintained the correlation and significantly increased the NPV to 97&#37;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Question 5 &#40;&#8220;How old are you&#63;&#8221;&#41; and question 6 &#40;&#8220;When were you born&#63;&#8221;&#41; had the highest PPV &#40;91&#37; and 93&#37;&#44; respectively&#41; and had a good correlation with respect to the full questionnaire&#46; The combination of the 2 questions maintained the correlation but did not&#44; however&#44; increase the PPV of the questions when considered individually&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">The main result of this study was the high NPV reached with the combination of questions 1 and 10 &#40;97&#37;&#41; on the SPMSQ&#44; such that both may be used as screening for cognitive impairment in polypathological patients&#46; Questions 5 and 6 had high PPV &#40;91&#37; and 93&#37;&#44; respectively&#41;&#44; although their combination did not improve the diagnostic validity indices&#46; A possible practical approach for the diagnosis of cognitive impairment in polypathological patients is outlined in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The results of this study should be interpreted within the context of its limitations&#46; As with all simplified screening tests&#44; negativity &#40;answering the 3 questions correctly&#41; safely rules out the presence of cognitive impairment&#46; Positivity &#40;incorrect answer to the date of birth or &#8220;What is the date today&#63;&#8221; and&#47;or &#8220;Count backwards by threes from 20&#8220;&#41; requires the confirmation of the cognitive impairment or dementia with more specific tests&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">In conclusion&#44; the combination of 2 questions on the SPMSQ &#40;&#8220;What is the date today&#63;&#8221; and &#8220;Count backwards by threes from 20&#8221;&#41; achieved a high NPV in the screening of cognitive impairment in polypathological patients&#44; while the question regarding the date of birth achieved a high PPV&#46; These findings should be validated in an independent cohort of patients&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Funding</span><p id="par0045" class="elsevierStylePara elsevierViewall">The study was funded by the Institute of Health Carlos III &#40;ISCIII&#44; FIS 07&#47;0047&#41;&#44; Ministry of Health and Consumer Affairs&#44; Spain</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:10 [
        0 => array:3 [
          "identificador" => "xres875311"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objectives"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec863506"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres875310"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivos"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec863505"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Background"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Material and methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Funding"
        ]
        9 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-12-29"
    "fechaAceptado" => "2017-03-15"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec863506"
          "palabras" => array:5 [
            0 => "Polypathology"
            1 => "Cognitive impairment"
            2 => "Screening"
            3 => "Pfeiffer questionnaire"
            4 => "SPMSQ"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec863505"
          "palabras" => array:5 [
            0 => "Pluripatolog&#237;a"
            1 => "Deterioro cognitivo"
            2 => "Cribado"
            3 => "Cuestionario de Pfeiffer"
            4 => "SPMSQ"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To analyze the correlation&#44; sensitivity&#44; specificity and positive predictive &#40;PPV&#41; and negative predictive &#40;NPV&#41; values of each question on the Pfeiffer questionnaire &#40;SPMSQ&#41; compared with the full questionnaire for polypathological patients &#40;PPPs&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Multicentre cross-sectional study&#46; An SPMSQ score is considered pathological if 3 or more errors are recorded&#46; For each question and combination of 2 questions&#44; we calculated the correlation &#40;kappa index&#41;&#44; sensitivity&#44; specificity and predictive values compared with the full SPMSQ&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Of the 1632 PPPs included &#40;mean age&#44; 77&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;8 years&#44; 53&#37; men&#41;&#44; 1434 performed the SPMSQ &#40;the remaining presented delirium&#41;&#59; 39&#37; of the PPPs were pathological&#46; The question &#8220;What day is it today&#63;&#8221; and the command &#8220;Count backwards by 3s from 20&#8221; obtained good correlation and NPV &#40;85 and 89&#37;&#44; respectively&#41;&#59; the combination of both increased the NPV to 97&#37;&#46; The question &#8220;When were you born&#63;&#8217; achieved good correlation and greater PPV &#40;93&#37;&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The combination of the question &#8220;What day is it today&#63;&#8221; and the command &#8220;Count backwards by 3s from 20&#8221; achieved a high NPV&#46; The question related to the date of birth achieved the highest PPV&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Analizar la concordancia&#44; sensibilidad&#44; especificidad y valores predictivos positivo &#40;VPP&#41; y negativo &#40;VPN&#41; de cada pregunta del cuestionario de Pfeiffer &#40;SPMSQ&#41; con respecto al cuestionario completo en pacientes pluripatol&#243;gicos &#40;PPP&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal multic&#233;ntrico&#46; El SPMSQ se consider&#243; patol&#243;gico si se registraban 3 o m&#225;s errores&#46; Para cada pregunta y combinaciones de 2 preguntas se calcularon la concordancia &#40;&#237;ndice <span class="elsevierStyleItalic">kappa</span>&#41;&#44; sensibilidad&#44; especificidad y valores predictivos con respecto al SPMSQ completo&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">De los 1&#46;632 pacientes pluripatol&#243;gicos incluidos &#40;edad media 77&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;8 a&#241;os&#44; 53&#37; varones&#41;&#44; se realiz&#243; el SPMSQ a 1&#46;434 &#40;los restantes presentaban <span class="elsevierStyleItalic">delirium</span>&#41; y result&#243; patol&#243;gico en el 39&#37;&#46; Las preguntas &#171;&#191;qu&#233; d&#237;a es hoy&#63;&#187; y &#171;reste de 3 en 3 desde 20&#187; obtuvieron buena concordancia y VPN &#40;85&#37; y 89&#37;&#44; respectivamente&#41;&#59; la combinaci&#243;n de ambas aument&#243; el VPN al 97&#37;&#46; La pregunta &#171;&#191;cu&#225;ndo naci&#243;&#63;&#187; alcanz&#243; buena concordancia y el mayor VPP &#40;93&#37;&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La combinaci&#243;n de las preguntas &#171;&#191;qu&#233; d&#237;a es hoy&#63;&#187; y &#171;reste de 3 en 3 desde 20&#187; obtuvo un VPN elevado&#44; y la relacionada con la fecha de nacimiento fue la que consigui&#243; el mayor VPP&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:3 [
        "etiqueta" => "&#9674;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">More information about the members of the PROFUND Project can be found in <a class="elsevierStyleCrossRef" href="#sec0030">Appendix 1</a>&#46;</p>"
        "identificador" => "fn0005"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Bernabeu-Wittel M&#44; Nieto Mart&#237;n D&#44; Moreno-Gavi&#241;o L&#44; Ollero-Baturone M&#44; on behalf of researchers from the Proyecto Profund&#46; Valor diagn&#243;stico de un cuestionario de Pfeiffer simplificado en pacientes pluripatol&#243;gicos&#46; Rev Clin Esp&#46; 2017&#59;217&#58;320&#8211;324&#46;</p>"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0050" class="elsevierStylePara elsevierViewall">M&#225;ximo Bernabeu-Wittel&#44; Manuel Ollero-Baturone&#44; Javier Galindo-Oca&#241;a&#44; M&#46; Dolores Nieto-Mart&#237;n&#44; Lourdes Moreno-Gavi&#241;o&#44; Nieves Ram&#237;rez-Duque&#44; Manuel Cassani-Garza&#44; Manuel Rinc&#243;n-G&#243;mez&#59; Hospital Virgen del Roc&#237;o&#44; Sevilla&#46;</p> <p id="par0055" class="elsevierStylePara elsevierViewall">Aurelio Fuertes-Mart&#237;n&#44; Ignacio Novo Valeiro&#44; Guillermo Ternavasio&#44; Cristina de la Calle-Cabrera&#44; Hern&#225;n Llorente-Cancho&#44; Sandra G&#243;mez-Lesmes&#44; Mar&#237;a Sanchez-Ledesma&#59; University Hospital&#44; Salamanca&#46;</p> <p id="par0060" class="elsevierStylePara elsevierViewall">Bosco Bar&#243;n-Franco&#44; Alberto Escalera-Zalvide&#44; Tom&#225;s Mart&#237;nez&#59; Hospital Juan Ram&#243;n Jim&#233;nez&#44; Huelva&#46;</p> <p id="par0065" class="elsevierStylePara elsevierViewall">Jos&#233; Murcia-Zaragoza&#59; General Hospital of Alicante&#46;</p> <p id="par0070" class="elsevierStylePara elsevierViewall">Carmen Ramos-Cantos&#44; Carlos Sanrom&#225;n&#59; Hospital de la Axarqu&#237;a&#44; Malaga&#46;</p> <p id="par0075" class="elsevierStylePara elsevierViewall">Antonio Alem&#225;n&#59; Hospital Morales Meseguer&#44; Murcia&#46;</p> <p id="par0080" class="elsevierStylePara elsevierViewall">Antonio Fern&#225;ndez-Moyano&#59; Hospital San Juan de Dios del Aljarafe&#44; Seville&#46;</p> <p id="par0085" class="elsevierStylePara elsevierViewall">Antonia Mora-Rufete&#59; General Hospital of Elche&#46;</p> <p id="par0090" class="elsevierStylePara elsevierViewall">Jos&#233; Barb&#233; Gil-Ortega&#44; Antonio Sanjos&#233;-Laporte&#59; Hospital Vall d&#8217;Hebr&#243;n&#44; Barcelona&#46;</p> <p id="par0095" class="elsevierStylePara elsevierViewall">Virginia Rodr&#237;guez-Mart&#237;nez&#44; Felipe D&#237;ez&#59; Hospital of Torrec&#225;rdenas&#44; Almeria&#46;</p> <p id="par0100" class="elsevierStylePara elsevierViewall">Carolina Luque-Amado&#44; Mar&#237;a Maiz-Jim&#233;nez&#44; Montserrat Godoy&#44; Alberto Ruiz-Cantero&#59; Hospital de la Serran&#237;a&#44; Malaga&#46;</p> <p id="par0105" class="elsevierStylePara elsevierViewall">Manuel Romero-Jim&#233;nez&#59; Hospital Infanta Elena&#44; Huelva&#46;</p> <p id="par0110" class="elsevierStylePara elsevierViewall">M&#46; &#193;ngeles Soria-L&#243;pez&#59; Clinic Virgen de la Vega&#44; Murcia&#46;</p> <p id="par0115" class="elsevierStylePara elsevierViewall">Francisco Mart&#237;nez&#44; Mariano Aguayo-Canela&#59; Hospital Virgen Macarena&#44; Seville&#46;</p> <p id="par0120" class="elsevierStylePara elsevierViewall">Jes&#250;s Medina&#59; Hospital 12 de Octubre&#44; Madrid</p> <p id="par0125" class="elsevierStylePara elsevierViewall">Pilar Giner&#59; Hospital San Cecilio&#44; Granada&#46;</p> <p id="par0130" class="elsevierStylePara elsevierViewall">Beatriz Massa&#59; Hospital of Villajoyosa&#44; Alicante&#46;</p> <p id="par0135" class="elsevierStylePara elsevierViewall">Manuel Francisco Fern&#225;ndez-Miera&#59; Hospital Marqu&#233;s de Valdecilla&#44; Santander&#46;</p> <p id="par0140" class="elsevierStylePara elsevierViewall">Sixto Ruiz&#59; Hospital of Inca&#44; Mallorca&#46;</p> <p id="par0145" class="elsevierStylePara elsevierViewall">Jos&#233; Manuel Mach&#237;n-L&#225;zaro&#59; Hospital of Guadalajara</p> <p id="par0150" class="elsevierStylePara elsevierViewall">Jordi Aligu&#233;&#44; Clotilde Morales&#59; Hospital of Manresa&#44; Barcelona&#46;</p> <p id="par0155" class="elsevierStylePara elsevierViewall">Luis Feliu-Mazaria&#59; General Hospital of Palma&#44; Mallorca&#46;</p> <p id="par0160" class="elsevierStylePara elsevierViewall">Francesc Formiga&#59; Hospital of Bellvitge&#44; Barcelona&#46;</p> <p id="par0165" class="elsevierStylePara elsevierViewall">Emilio Sacanella&#59; Clinic Hospital&#44; Barcelona&#46;</p> <p id="par0170" class="elsevierStylePara elsevierViewall">M&#46; Luisa Rodr&#237;guez-Benedito&#59; General Hospital of Requena&#44; Valencia&#46;</p> <p id="par0175" class="elsevierStylePara elsevierViewall">Manuela Castillo-Blasco&#44; Pedro Tenllado-Doblas&#59; Hospital Dr Moliner&#44; Valencia&#46;</p> <p id="par0180" class="elsevierStylePara elsevierViewall">Manuel Montero P&#233;rez-Barquero&#59; Hospital Reina Sof&#237;a&#44; Cordoba&#46;</p> <p id="par0185" class="elsevierStylePara elsevierViewall">Eulalia Villegas-Bruguera&#59; Hospital Dos de Maig&#44; Barcelona&#46;</p> <p id="par0190" class="elsevierStylePara elsevierViewall">Blanca Pinilla&#59; Hospital Gregorio Mara&#241;&#243;n&#44; Madrid&#46;</p> <p id="par0195" class="elsevierStylePara elsevierViewall">Lucy Abella-V&#225;zquez&#44; Alicia Tejera-Concepci&#243;n&#59; Hospital Nuestra Sra&#46; de la Candelaria&#44; Tenerife&#46;</p> <p id="par0200" class="elsevierStylePara elsevierViewall">Jordy Forteza-Rey&#59; Hospital Son Dureta&#44; Mallorca&#46;</p> <p id="par0205" class="elsevierStylePara elsevierViewall">Jes&#250;s D&#237;ez-Manglano&#59; Hospital Royo Villanova&#44; Zaragoza&#46;</p> <p id="par0210" class="elsevierStylePara elsevierViewall">Francisco Medrano-Gonz&#225;lez&#59; Hospital of Albacete&#46;</p> <p id="par0215" class="elsevierStylePara elsevierViewall">Francisco Martos&#59; Hospital of Benalm&#225;dena&#44; Malaga&#46;</p> <p id="par0220" class="elsevierStylePara elsevierViewall">Alberto Muela-Molinero&#59; Hospital of Le&#243;n&#46;</p> <p id="par0225" class="elsevierStylePara elsevierViewall">M&#243;nica Albert-Coll&#59; Hospital of Manacor&#44; Mallorca&#46;</p>"
            "etiqueta" => "Appendix 1"
            "titulo" => "Project PROFUND Researchers"
            "identificador" => "sec0030"
          ]
        ]
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1445
            "Ancho" => 2093
            "Tamanyo" => 179408
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Proposal for a practical approach for screening cognitive impairment in polypathological patients&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">95&#37; confidence interval between brackets&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Question 1&#58; &#8220;What is the date today&#63; &#40;day&#44; month and year&#41;&#8221;&#59; Question 2&#58; &#8220;What day of the week is it today&#63;&#8221;&#59; Question 3&#58; &#8220;What is the name of this location&#63;&#8221;&#59; Question 4&#58; &#8220;What is your telephone number&#63;&#8221; &#40;if the patient does not have a telephone&#44; ask them their address&#41;&#59; Question 5&#58; &#8220;How old are you&#63;&#8221;&#59; Question 6&#58; &#8220;When were you born&#63;&#8221;&#59; Question 7&#58; &#8220;Who is the current head of the government&#63;&#8221;&#59; Question 8&#58; &#8220;Who was the previous head&#63;&#8221;&#59; Question 9&#58; &#8220;What is your mother&#39;s maiden name&#63;&#8221;&#59; Question 10&#58; &#8220;Count backwards by threes from 20&#8221;&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; Kappa&#44; index of agreement&#59; S&#44; sensitivity&#59; Sp&#44; specificity&#59; PPV&#44; positive predictive value&#59; NPV&#44; negative predictive value&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Questions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">kappa</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">S&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">PPV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NPV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;67 &#91;0&#46;63&#8211;0&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78&#37; &#91;75&#8211;81&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#37; &#91;85&#8211;90&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82&#37; &#91;79&#8211;85&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85&#37; &#91;82&#8211;87&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;56 &#91;0&#46;52&#8211;0&#46;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#37; &#91;54&#8211;62&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95&#37; &#91;93&#8211;96&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&#37; &#91;86&#8211;92&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#37; &#91;74&#8211;78&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;37 &#91;0&#46;32&#8211;0&#46;43&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#37; &#91;34&#8211;41&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#37; &#91;95&#8211;98&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&#37; &#91;85&#8211;93&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&#37; &#91;66&#8211;71&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;66 &#91;0&#46;62&#8211;0&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#37; &#91;67&#8211;74&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93&#37; &#91;91&#8211;94&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#37; &#91;84&#8211;90&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82&#37; &#91;79&#8211;84&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;39 &#91;0&#46;34&#8211;0&#46;44&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#37; &#91;35&#8211;42&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#37; &#91;96&#8211;98&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91&#37; &#91;87&#8211;94&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69&#37; &#91;66&#8211;71&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;56 &#91;0&#46;52&#8211;0&#46;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#37; &#91;43&#8211;51&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#37; &#91;96&#8211;98&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93&#37; &#91;89&#8211;95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72&#37; &#91;69&#8211;74&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question 7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;6 &#91;0&#46;56&#8211;0&#46;64&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#37; &#91;60&#8211;68&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">94&#37; &#91;92&#8211;95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#37; &#91;85&#8211;90&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78&#37; &#91;76&#8211;81&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question 8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;67 &#91;0&#46;63&#8211;0&#46;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75&#37; &#91;71&#8211;78&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91&#37; &#91;89&#8211;93&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85&#37; &#91;82&#8211;88&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#37; &#91;81&#8211;86&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question 9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;41 &#91;0&#46;36&#8211;0&#46;46&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#37; &#91;37&#8211;45&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#37; &#91;95&#8211;99&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&#37; &#91;86&#8211;93&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69&#37; &#91;67&#8211;72&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Question 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;55 &#91;0&#46;51&#8211;0&#46;59&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#37; &#91;85&#8211;90&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69&#37; &#91;66&#8211;72&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#37; &#91;64&#8211;71&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&#37; &#91;86&#8211;91&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Questions 1 and&#47;or 10<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;57 &#91;0&#46;53&#8211;0&#46;62&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98&#37; &#91;96&#8211;99&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#37; &#91;60&#8211;69&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#37; &#91;63&#8211;69&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#37; &#91;96&#8211;98&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Questions 1 and&#47;or 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;71 &#91;0&#46;7&#8211;0&#46;75&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#37; &#91;81&#8211;87&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87&#37; &#91;85&#8211;89&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82&#37; &#91;79&#8211;85&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#37; &#91;86&#8211;90&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Questions 5 and&#47;or 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;57 &#91;0&#46;53&#8211;0&#46;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#37; &#91;53&#8211;61&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">97&#37; &#91;96&#8211;98&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93&#37; &#91;90&#8211;95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&#37; &#91;73&#8211;78&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Questions 2 and&#47;or 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;7 &#91;0&#46;65&#8211;0&#46;73&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72&#37; &#91;69&#8211;76&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95&#37; &#91;93&#8211;96&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&#37; &#91;88&#8211;93&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&#37; &#91;80&#8211;85&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1477427.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">The answer is considered in error if the patient answers 1 or 2 questions incorrectly&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Statistical analysis of each question on the Pfeiffer questionnaire &#40;incorrect answer&#41; and their combinations in a sample of 1632 polypathological patients&#44; considering the reference standard of cognitive impairment to be 3 or more incorrect answers in the questionnaire&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Caracter&#237;sticas cl&#237;nicas&#44; funcionales&#44; mentales y sociales de pacientes pluripatol&#243;gicos&#46; Estudio prospectivo durante un a&#241;o en Atenci&#243;n Primaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46; Ram&#237;rez-Duque"
                            1 => "M&#46; Ollero-Baturone"
                            2 => "M&#46; Bernabeu-Wittel"
                            3 => "M&#46; Rinc&#243;n-G&#243;mez"
                            4 => "M&#46;A&#46; Ortiz-Camu&#241;ez"
                            5 => "S&#46; Garcia-Morillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2008"
                        "volumen" => "208"
                        "paginaInicial" => "4"
                        "paginaFinal" => "11"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18221654"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of cognitive impairment in a multicentric cohort of polypathological patients"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "on behalf of PROFUND Project researchers"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Moreno-Gavi&#241;o"
                            1 => "A&#46; Ruiz-Cantero"
                            2 => "M&#46; Bernabeu-Wittel"
                            3 => "A&#46; Tejera-Concepci&#243;n"
                            4 => "M&#46; Romero-Jim&#233;nez"
                            5 => "M&#46;A&#46; Soria"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Gerontol"
                        "fecha" => "2012"
                        "volumen" => "6"
                        "paginaInicial" => "84"
                        "paginaFinal" => "89"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dementia in the acute hospital prospective cohort study of prevalence and mortality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;L&#46; Sampson"
                            1 => "M&#46;R&#46; Blanchard"
                            2 => "L&#46; Jones"
                            3 => "A&#46; Tookman"
                            4 => "M&#46; King"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1192/bjp.bp.108.055335"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Psychiatry"
                        "fecha" => "2009"
                        "volumen" => "195"
                        "paginaInicial" => "61"
                        "paginaFinal" => "66"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19567898"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mild cognitive impairment in the older population&#58; who is missed and does it matter&#63;"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Medical Research Council Cognitive Function and Ageing Study"
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46;C&#46; Stephan"
                            1 => "C&#46; Brayne"
                            2 => "I&#46;G&#46; McKeith"
                            3 => "J&#46; Bond"
                            4 => "F&#46;E&#46; Matthews"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/gps.2013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Geriatr Psychiatry"
                        "fecha" => "2008"
                        "volumen" => "23"
                        "paginaInicial" => "863"
                        "paginaFinal" => "871"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18537198"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A short portable mental status questionnaire for the assessment of organic brain deficits in elderly patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "E&#46;A&#46; Pfeiffer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Geriatr Soc"
                        "fecha" => "1975"
                        "volumen" => "22"
                        "paginaInicial" => "433"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4422934"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adaptaci&#243;n y validaci&#243;n al castellano del cuestionario de Pfeiffer &#40;SPMSQ&#41; para detectar la existencia de deterioro cognitivo en personas mayores de 65 a&#241;os"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Martinez"
                            1 => "R&#46; Duenas"
                            2 => "M&#46;C&#46; Onis"
                            3 => "C&#46; Aguado"
                            4 => "C&#46; Albert"
                            5 => "R&#46; Luque"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2001"
                        "volumen" => "117"
                        "paginaInicial" => "129"
                        "paginaFinal" => "134"
                        "itemHostRev" => array:3 [
                          "pii" => "S2215036614703098"
                          "estado" => "S300"
                          "issn" => "22150366"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validaci&#243;n del cuestionario de Pfeiffer y la escala de incapacidad mental de la Cruz Roja en la detecci&#243;n del deterioro mental en los pacientes externos de un servicio de geriatr&#237;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;I&#46; Gonz&#225;lez-Montalvo"
                            1 => "L&#46; Rodr&#237;guez"
                            2 => "I&#46; Ruip&#233;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Esp Geriatr Gerontol"
                        "fecha" => "1992"
                        "volumen" => "27"
                        "paginaInicial" => "129"
                        "paginaFinal" => "133"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluaci&#243;n preliminar de un nuevo test de cribado de demencia &#40;Eurotest&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Carnero-Pardo"
                            1 => "M&#46;T&#46; Montoro-R&#237;os"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Neurol"
                        "fecha" => "2004"
                        "volumen" => "38"
                        "paginaInicial" => "201"
                        "paginaFinal" => "209"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14963845"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A multi-institutional&#44; hospital-based assessment of clinical&#44; functional&#44; sociofamilial&#44; and health-care characteristics of polypathological patients"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "on behalf of the Profund Researchers"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Bernabeu-Wittel"
                            1 => "B&#46; Bar&#243;n-Franco"
                            2 => "J&#46; Murcia-Zaragoza"
                            3 => "A&#46; Fuertes-Mart&#237;n"
                            4 => "C&#46; Ramos-Cantos"
                            5 => "A&#46; Fern&#225;ndez-Moyano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.archger.2010.12.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Gerontol Geriatr"
                        "fecha" => "2011"
                        "volumen" => "53"
                        "paginaInicial" => "284"
                        "paginaFinal" => "291"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21215467"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clarifying confusion&#58; the confusion assessment method&#46; A new method for detection of delirium"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;K&#46; Inouye"
                            1 => "C&#46;H&#46; vanDyck"
                            2 => "C&#46;A&#46; Alessi"
                            3 => "S&#46; Balkin"
                            4 => "A&#46;P&#46; Siegal"
                            5 => "R&#46;I&#46; Horwitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1990"
                        "volumen" => "113"
                        "paginaInicial" => "941"
                        "paginaFinal" => "948"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2240918"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/22548874/0000021700000006/v1_201707280038/S225488741730070X/v1_201707280038/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "1903"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Brief Original"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021700000006/v1_201707280038/S225488741730070X/v1_201707280038/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S225488741730070X?idApp=WRCEE"
]
Share
Journal Information
Vol. 217. Issue 6.
Pages 320-324 (August - September 2017)
Share
Share
Download PDF
More article options
Visits
9
Vol. 217. Issue 6.
Pages 320-324 (August - September 2017)
Brief Original
Diagnostic value of a simplified Pfeiffer questionnaire for polypathological patients
Valor diagnóstico de un cuestionario de Pfeiffer simplificado en pacientes pluripatológicos
Visits
9
M. Bernabeu-Wittela,b,
Corresponding author
wittel@cica.es

Corresponding author.
, D. Nieto Martína,b, L. Moreno-Gaviñoa, M. Ollero-Baturonea, on behalf of researchers from the Proyecto Profund
a Unidad Clínica de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, Spain
b Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Instituto de Salud Carlos III, Madrid, Spain
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (1)
Table 1. Statistical analysis of each question on the Pfeiffer questionnaire (incorrect answer) and their combinations in a sample of 1632 polypathological patients, considering the reference standard of cognitive impairment to be 3 or more incorrect answers in the questionnaire.
Abstract
Objectives

To analyze the correlation, sensitivity, specificity and positive predictive (PPV) and negative predictive (NPV) values of each question on the Pfeiffer questionnaire (SPMSQ) compared with the full questionnaire for polypathological patients (PPPs).

Methods

Multicentre cross-sectional study. An SPMSQ score is considered pathological if 3 or more errors are recorded. For each question and combination of 2 questions, we calculated the correlation (kappa index), sensitivity, specificity and predictive values compared with the full SPMSQ.

Results

Of the 1632 PPPs included (mean age, 77.9±9.8 years, 53% men), 1434 performed the SPMSQ (the remaining presented delirium); 39% of the PPPs were pathological. The question “What day is it today?” and the command “Count backwards by 3s from 20” obtained good correlation and NPV (85 and 89%, respectively); the combination of both increased the NPV to 97%. The question “When were you born?’ achieved good correlation and greater PPV (93%).

Conclusions

The combination of the question “What day is it today?” and the command “Count backwards by 3s from 20” achieved a high NPV. The question related to the date of birth achieved the highest PPV.

Keywords:
Polypathology
Cognitive impairment
Screening
Pfeiffer questionnaire
SPMSQ
Resumen
Objetivos

Analizar la concordancia, sensibilidad, especificidad y valores predictivos positivo (VPP) y negativo (VPN) de cada pregunta del cuestionario de Pfeiffer (SPMSQ) con respecto al cuestionario completo en pacientes pluripatológicos (PPP).

Métodos

Estudio transversal multicéntrico. El SPMSQ se consideró patológico si se registraban 3 o más errores. Para cada pregunta y combinaciones de 2 preguntas se calcularon la concordancia (índice kappa), sensibilidad, especificidad y valores predictivos con respecto al SPMSQ completo.

Resultados

De los 1.632 pacientes pluripatológicos incluidos (edad media 77,9±9,8 años, 53% varones), se realizó el SPMSQ a 1.434 (los restantes presentaban delirium) y resultó patológico en el 39%. Las preguntas «¿qué día es hoy?» y «reste de 3 en 3 desde 20» obtuvieron buena concordancia y VPN (85% y 89%, respectivamente); la combinación de ambas aumentó el VPN al 97%. La pregunta «¿cuándo nació?» alcanzó buena concordancia y el mayor VPP (93%).

Conclusiones

La combinación de las preguntas «¿qué día es hoy?» y «reste de 3 en 3 desde 20» obtuvo un VPN elevado, y la relacionada con la fecha de nacimiento fue la que consiguió el mayor VPP.

Palabras clave:
Pluripatología
Deterioro cognitivo
Cribado
Cuestionario de Pfeiffer
SPMSQ

Article

These are the options to access the full texts of the publication Revista Clínica Española (English Edition)
Member
Si es usted socio de FESEMI siga los siguientes pasos:

Diríjase desde aquí a la web de la >>>FESEMI<<< e inicie sesión mediante el formulario que se encuentra en la barra superior, pulsando sobre el candado.

Una vez autentificado, en la misma web de FESEMI, en el menú superior, elija la opción deseada.

>>>FESEMI<<<

Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Clínica Española (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Revista Clínica Española (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?