***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Illiteracy , a universal problem , limits the utilization of the most widely used short cognitive tests . Our objective was to assess and compare the effectiveness and cost for cognitive impairment ( CI ) and dementia ( DEM ) screening of three short cognitive tests applicable to illiterates . Methods Phase III diagnostic test evaluation study was performed during one year in four Primary Care centers , prospect ively including individuals with suspicion of CI or DEM . All underwent the Eurotest , Memory Alteration Test ( M@T ) , and Phototest , applied in a balanced manner . Clinical , functional , and cognitive studies were independently performed in a blinded fashion in a Cognitive Behavioral Neurology Unit , and the gold st and ard diagnosis was established by consensus of expert neurologists on the basis of these results . Effectiveness of tests was assessed as the proportion of correct diagnoses ( diagnostic accuracy [ DA ] ) and the kappa index of concordance ( k ) with respect to gold st and ard diagnoses . Costs were based on public prices at the time and hospital accounts . Results The study included 139 individuals : 47 with DEM , 36 with CI , and 56 without CI . No significant differences in effectiveness were found among the tests . For DEM screening : Eurotest ( k = 0.71 [ 0.59–0.83 ] , DA = 0.87 [ 0.80–0.92 ] ) , M@T ( k = 0.72 [ 0.60–0.84 ] , DA = 0.87 [ 0.80–0.92 ] ) , Phototest ( k = 0.70 [ 0.57–0.82 ] , DA = 0.86 [ 0.79–0.91 ] ) . For CI screening : Eurotest ( k = 0.67 [ 0.55–0.79 ] ; DA = 0.83 [ 0.76–0.89 ] ) , M@T ( k = 0.52 [ 0.37–0.67 ] ; DA = 0.80 [ 0.72–0.86 ] ) , Phototest ( k = 0.59 [ 0.46–0.72 ] ; DA = 0.79 [ 0.71–0.86 ] ) . There were no differences in the cost of DEM screening , but the cost of CI screening was significantly higher with M@T ( 330.7±177.1 € , mean±sd ) than with Eurotest ( 294.1±195.0 € ) or Phototest ( 296.0±196.5 € ) . Application time was shorter with Phototest ( 2.8±0.8 min ) than with Eurotest ( 7.1±1.8 min ) or M@T ( 6.8±2.2 min ) . Conclusions Eurotest , M@T , and Phototest are equally effective . Eurotest and Phototest are both less expensive options but Phototest is the most efficient , requiring the shortest application time INTRODUCTION The changeover to the new currency has meant that the Money test , a screening test for dementia with a number of advantages over those currently available , is now of no use . AIMS Our aim was to perform a preliminary evaluation of the Eurotest , which is a version of the Money test adapted to the new currency system . SUBJECTS AND METHODS DESIGN phase I , diagnostic evaluation ( convenience sampling ; pre-test prevalence 50 % ) . SUBJECTS > 65 years with no sensory deficit ; 30 with mild dementia and 30 without dementia . METHOD evaluation of socio-demographic variables and of  mini-mental performance ( MMSE ) , Pfeiffer 's test ( SPMSQ ) , the seven-minute test ( 7MT ) and Eurotest .  Statistical study : comparison between groups using t test and chi squared , depending on the variables ; determination of diagnostically useful parameters and ROC curves , with their respective 95 % confidence intervals ; linear regression study with a step by step strategy . RESULTS The groups did not differ as regards age , sex , level of schooling , degree of literacy , employment and knowledge of money systems . The Eurotest has a sensitivity of 0.93 ( 0.76 - 0.99 ) and a specificity of 0.87 ( 0.68 - 0.96 ) , which is similar to that of the MMSE and the 7MT . The Eurotest ( 6.77 + /- 1.65 min ) takes less time than the 7MT ( 8.87 + /- 1.81 min ) and is not modified by the subject 's clinical situation . The level of schooling does not affect the results of the Eurotest . CONCLUSIONS The Eurotest is simple , quick , valid , useful and is unaffected by the level of schooling , which are features that make it a valid alternative to the tests currently available Background To assess and compare the effectiveness and costs of Phototest , Mini Mental State Examination ( MMSE ) , and Memory Impairment Screen ( MIS ) to screen for dementia ( DEM ) and cognitive impairment ( CI ) . Methods A phase III study was conducted over one year in consecutive patients with suspicion of CI or DEM at four Primary Care ( PC ) centers . After undergoing all screening tests at the PC center , participants were extensively evaluated by research ers blinded to screening test results in a Cognitive-Behavioral Neurology Unit ( CBNU ) . The gold st and ard diagnosis was established by consensus of expert neurologists . Effectiveness was assessed by the proportion of correct diagnoses ( diagnostic accuracy [ DA ] ) and by the kappa index of concordance between test results and gold st and ard diagnoses . Costs were based on public prices and hospital accounts . Results The study included 140 subjects ( 48 with DEM , 37 with CI without DEM , and 55 without CI ) . The MIS could not be applied to 23 illiterate subjects ( 16.4 % ) . For DEM , the maximum effectiveness of the MMSE  was obtained with different cutoff points as a function of educational level [ k = 0.31 ( 95 % Confidence interval [ 95%CI ] , 0.19 - 0.43 ) , DA = 0.60 ( 95%CI , 0.52 - 0.68 ) ] , and that of the MIS with a cutoff of 3/4 [ k = 0.63 ( 95%CI , 0.48 - 0.78 ) , DA = 0.83 ( 95%CI , 0.80 - 0.92 ) ] . Effectiveness of the Phototest  [ k = 0.71 ( 95%CI , 0.59 - 0.83 ) , DA = 0.87 ( 95%CI , 0.80 - 0.92 ) ] was similar to that of the MIS  and higher than that of the MMSE . Costs were higher  with MMSE ( 275.9 ± 193.3 € [ mean ± sd euros ] ) than with Phototest ( 208.2 ± 196.8 € ) or MIS ( 201.3 ± 193.4 € ) , whose costs did not significantly differ . For CI , the effectiveness did not significantly differ between MIS [ k = 0.59 ( 95%CI , 0.45 - 0.74 ) , DA = 0.79 ( 95%CI , 0.64 - 0.97 ) ] and Phototest [ k = 0.58 ( 95%CI , 0.45 - 0.74 ) , DA = 0.78 ( 95%CI , 0.64 - 0.95 ) ] and was lowest for the MMSE [ k = 0.27 ( 95%CI , 0.09 - 0.45 ) , DA = 0.69 ( 95%CI , 0.56 - 0.84 ) ] . Costs were higher for MMSE ( 393.4 ± 121.8 € ) than for Phototest ( 287.0 ± 197.4 € ) or MIS ( 300.1 ± 165.6 € ) , whose costs did not significantly differ . Conclusion MMSE is not an effective instrument in our setting . For both DEM and CI , the Phototest and MIS are more effective and less costly , with no difference between them . However , MIS could not be applied to the appreciable percentage of our population who were illiterate OBJECTIVE Fototest is a short simple test , applicable to illiterate subjects and not influenced by educational level . The purpose of this study is to assess its validity for cognitive impairment ( CI ) and dementia ( DEM ) under routine clinical practice conditions . MATERIAL AND METHODS A cross-sectional , multicentre and naturalistic study conducted in General Neurology clinics . The subjects were , over 60 years old , with a previously established diagnosis of no cognitive impairment ( NoCI ) , cognitive impairment without dementia ( CInoDEM ) , or dementia ( DEM ) . The discriminant validity was assessed using the area under the ROC curve ( AUC ) , sensitivity ( Sn ) , specificity ( Sp ) , and probability coefficients . Partial correlations were calculated , adjusted for age , sex and education level with Eurotest , verbal fluency test ( VFT ) and Global Deterioration Scale ( GDS ) score to evaluate the concurrent and construct validity . RESULTS Nineteen neurologists included a total of 589 subjects : 361 NoCI , 106 CINoDEM and 122 DEM .  The discriminant value was better for DEM ( AUC 0.94 ± 0.02 ) than for CI ( 0.86 ± 0.02 ) . For DEM the best cut-off point was 26/27 ( Sn=0.88 [ 95 % CI , 0.93 - 0.97 ] , Sp=0.87 [ 95 % CI , 0.84 - 0.90 ] ) ; and for CI , 28/29 ( Sn=0.71 [ 95 % CI , 0.65 - 0.77 ] , Sp=0.84 [ 95 % CI , 0.80 - 0.88 ] ) . Fototest showed a high and significant correlation with Eurotest ( r=0.70 ± 0.02 ) , VFT ( r=0.68 ± 0.02 ) and the GDS score ( r=-0.77 ± 0.02 ) . CONCLUSION The Fototest showed adequate validity for CI and DEM in general Neurology clinics in an extensive and wide geographical area INTRODUCTION The recently developed Phototest is a simple , easy and very brief ( <3 minutes ) test with theoretical advantages over available dementia screening tests . Our objective was to evaluate its diagnostic accuracy under routine clinical conditions . MATERIAL AND METHODS A phase II cross-sectional validation study of diagnostic tests was performed in a sample of 308 patients referred to a general neurology department and in a group of 70 healthy individuals . The diagnostic accuracy ( DA ) of the Phototest was assessed and compared with that of the  Eurotest and a verbal fluency test ( VFT )  in relation to the clinical diagnosis of dementia ( DEM ) and cognitive impairment ( CI ) by calculating the area under the ROC curve ( aROC ) and determining Sensitivity ( Se ) , Specificity ( Sp ) and likelihood ratios . RESULTS The total sample comprised 225 subjects without CI ( NOR ) , 58 with CI and without DEM and 95 with DEM .  Phototest results showed a normal distribution in NOR subjects ( 33.4 + /- 3.9 [ mean + /- st and ard desviation ] ) and were not influenced by educational variables . The DA of the Phototest for DEM and CI ( 0.95 + /- 0.01 [ aRO C+/- Se ] ) was similar to that of the Eurotest and higher for both tests than that of the VFT . The cutoff points of 25/26 for DEM ( Se=0.88 [ 0.80 - 0.94 ] , Sp=0.90 [ 0.86- 0.93 ] ) and 28/29 for CI ( Se=0.90 [ 0.84 - 0.94 ] , Sp=0.90 [ 0.83 - 0.93 ] ) maximised the sum of Se and Sp . CONCLUSIONS The Phototest is a very short test of easy application that is applicable to illiterate subjects , uninfluenced by educational variables and useful to identify CI and DEM in routine clinical practice 
    Output:
    
Conclusion Phototest has good diagnostic accuracy for dementia and cognitive impairment .
It is brief , simple and can be used in illiterate persons .
This makes it suitable for use in primary care setting s and /or in subjects with low educational level