The Oxford Cognitive Screen for use with Australian people after stroke (OCS-AU): The adaptation process and determining cut scores for cognitive impairment using a cross-sectional normative study.
Colette Sanctuary, Luisa Hewitt, Nele Demeyere and 7 others
PMID 36047309WHAT IT FOUND
The Oxford Cognitive Screen was adapted for Australian English.
Normative data showed that Australian scores matched the original UK cut scores for almost all items, meaning clinicians can use the existing thresholds to identify specific cognitive deficits after stroke.
Key findings
01Australian normative data matched the original UK cut scores for 15 of 16 items in Version A and all 16 items in Version B.
02The Praxis item in Version A did not meet the statistical criteria for matching, so the original cut score was retained as a more lenient threshold to avoid misclassifying motor difficulties as cognitive impairment.
03Cultural adaptations included changing sentence reading tasks and substituting images (e.g., hippopotamus to giraffe) to ensure familiarity for Australian participants.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The normative sample was younger than the typical stroke population; only 45-47% of participants were over 65, whereas 71% of Australian stroke survivors are in this age group. The study excluded people with significant hearing or visual impairments and those scoring below 22 on the MMSE, which may limit applicability to more severely impaired patients. The sample was small (83 participants) and may not be fully representative of Aboriginal and Torres Strait Islander people or those from culturally and linguistically diverse backgrounds, despite some cultural adaptations. Version A had only 58 participants, falling short of the recommended minimum of 60.
Declared interests
Nele Demeyere, an author, developed and authored the original Oxford Cognitive Screen. The adaptation was conducted in partnership with the UK OCS team.
The easy way to misread this
Do not assume this tool has been tested for sensitivity and specificity against gold-standard neuropsychological assessment in this study. The paper establishes normative cut scores for the Australian population but does not report diagnostic accuracy data (sensitivity/specificity) for detecting post-stroke cognitive impairment compared to a reference standard.