Inter-rater and intra-rater reliability of the Chinese version of the short orientation-memory-concentration test in people with stroke.

The study included only 44 participants from one hospital rehabilitation department, and only 36 were analysed for the same-rater repeat testing, so the results may not apply to other stroke populations. Participants were not grouped by cognitive impairment level or stroke chronicity, so reliability may not hold for people with much worse or much better cognition than those studied. Most participants performed well on orientation and attention items, so the sample may not represent people with severe cognitive impairment. The test was repeated three times within 2 days, which may introduce a learning effect, especially on the address recall item. The study did not assess stroke severity, mood, or other factors that can affect cognitive performance. Item 6 was changed to Chinese zodiac animals, but many participants performed poorly because they had never memorised the order, even before stroke. Five of 44 inter-rater scores and two of 36 intra-rater scores fell outside the expected agreement limits. The study tested reliability only, not whether the C-SOMC accurately diagnoses cognitive impairment compared with a reference standard.

The authors declared financial support was received from the National Natural Science Foundation of China and the 5010 Planning Project of Sun Yat-Sen University.

Do not read this as proof that the Chinese SOMC accurately diagnoses dementia or cognitive impairment. The study showed that scores were stable and similar between raters, but it did not compare the test against a reference standard to show correct classification.