Objectives Utility of a simple 1 min cognitive screening tool, verbal fluency test, as a potential risk assessment tool for GPs for a suspected brain tumour.
Design Case-control study; patients with new diagnosis of brain tumour with a history of headache and patients referred for direct-access-CT for headache without a brain tumour.
Subjects 102 brain tumour patients: 34.3% HGG, meningioma 21.6%, cerebrals metastases 17.6%, LGG 11.8%, others (pituitary, schwannoma, haemangioblastoma) 11.8%, and CNS lymphoma 2.9%.
Methods Group differences analysed with ANCOVA with age/gender as covariates.
Results Mean age was similar across both groups. There were more females in the control group. Tumour patients obtained significantly lower scores on fluency test measures. The largest effect size difference was observed for semantic total and phonemic total scores (Cohen’s d=−0.97 and −0.47, respectively. Brain tumour patients named on average 4.9 animals less (95% CI −6.32,–3.42) (p<0.001) than controls. On letter P task, there was a 2.2 word-mean difference (95% CI −3.6,–0.86)(p=0.001). Forty-eight (47.1%) tumour patients and 22 (23.4%) controls had subjective memory disturbance. Tumour patients performed equally on both fluency tasks regardless of memory complaints (p>0.5).
Conclusions Semantic test is more reliable to discriminate patients with a brain tumour. In contrasts to patients without a brain tumour, subjective memory impairment is not associated with a reduced performance on verbal fluency tasks.
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