Examining the Clinical Utility of the Brief Interview for Mental Status.
Chih-Ying Li, Paul Arthur, Brian Downer and 4 others
PMID 35604887WHAT IT FOUND
The BIMS behaved mostly as one cognitive measure, but it could hardly separate patients in nursing homes and skilled nursing facilities into two cognitive levels, and 41.9% scored the maximum, so it may miss mild problems.
Key findings
01The BIMS behaved mostly as one cognitive measure, but it could hardly distinguish patients' cognitive levels into two groups.
02Person reliability was 0.43, suggesting the BIMS may not consistently estimate patients' cognitive levels in this population.
0341.9% of patients had the maximum BIMS score, indicating a ceiling effect.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only patients who could attempt or complete the BIMS and had no missing BIMS items were analysed, so the findings do not cover patients who cannot be understood or give responses. The sample was limited to older adults in Medicare fee-for-service, so results may not apply to patients with other insurance plans. DIF analysis only handled male versus female and White versus racial and ethnic minority groups, so it could not directly apply to Black/African American and Hispanic/Latino participants. The very large sample may have affected reliability indices, and the authors reported results as collected rather than removing potentially misfitting responses.
Declared interests
The authors disclosed no potential conflicts of interest. The paper is listed as receiving NIH extramural research support.
The easy way to misread this
Do not read a perfect BIMS score as evidence that cognition is normal. The scale had a ceiling effect, with 41.9% of patients scoring the maximum, and person reliability was 0.43, so it may miss mild cognitive problems.