The Neurobehavioral Cognitive Status Examination (NCSE) is a structured test of cognitive functioning. The NCSE assesses a broader range of cognitive functioning than the
Mini-Mental State Examination (MMSE), but remains brief enough to be administered at the bedside in clinical settings. The purpose of this study was to assess the sensitivity, specificity, predictive value and reliability of the NCSE as a clinical case-finding instrument for
DSM-III-R defined organic mental disorders in
psychiatric inpatients. Validity was assessed by comparing the results of the test (interpreted as "pass" or "fail") to a
blind clinical assessment by an experienced
psychiatrist. The NCSE was found to have superior sensitivity to the MMSE (83% versus 43%), but
inferior specificity (47% versus 97%). The low specificity resulted in a
positive predictive value of only 24%. The NCSE had good
test-retest reliability (Kappa = .69), but the
inter-rater reliability was not as good (Kappa = 0.57). The NCSE was too non-specific to be used as a case-finding instrument for organic mental disorders. In conclusion, although clinicians may find the NCSE to be a valuable instrument for the assessment of cognitive function, it cannot be used as a screening or case-finding instrument for organic disorders among
psychiatric inpatients.
