DOMS: Frequently Asked Questions

A quantitative rating system was developed based on 18 quality criteria relevant to the clinical assessment of dementia. This system allowed to compare the performance of similar scales, and to identify areas of strength and weakness. The criteria included a combination of the scale’s psychometric performance (13 criteria), adoption in dementia guidelines (1 criterion), user-friendliness (2 criteria), and cost (2 criteria). Psychometric criteria included separate ratings for different kinds of reliability (inter-rater, test-retest, internal consistency), validity (concurrent, discriminant, sensitivity, specificity, responsiveness) and generalisability (to different: dementia types, clinical settings and countries/languages).

Criteria for user-friendliness included ease of administration and scoring, or for informant scales, the cognitive burden on the respondent completing the scale. Criteria regarding cost included costs of purchasing or using the scale itself, costs of training to use the scale (when applicable), and the level of clinical qualifications required to administer the scale.

Based on a literature review of peer-reviewed publications for each scale, each criterion was scored as 0, 1 or 2 with a higher score reflecting a greater degree of support for that criterion. In most cases the criteria were quantified or where qualitative in nature were defined objectively. For example, for the diagnostic sensitivity of the scale the scales were scored as follows:

score 0: sensitivity < 0.70
score 1: sensitivity from 0.70 to 0.84
score 2: sensitivity ≥ 0.85

An overall score was derived by multiplying the score on each criterion by the weighting of that criterion, summing the totals and scaling to a total score out of 100. Full details of the entire set of rating criteria and the complete scale scores will be accessible from the domain pages (under construction).

On the page for each scale the Quality Rating box on the top categorises the scale’s overall score (out of 100) on all of our quality metrics as follows:

50–54: Fair
55–64: Good
65–79: Very good
80–100: Excellent

The DOMS review is based on an in-depth assessment of the scientific literature and features scales with sufficient evidence-based merit for the assessment of dementia. Even for commonly used instruments, the scientific evidence can sometimes be limited. Consult our rating overview for more information on how different measures were evaluated.
If you are concerned about your own memory or that of a family member or friend, please consult your doctor. This site is directed at health professionals who have undergone suitable training for use of clinical tools. These tools should not be used to assess yourself or a loved one, for many reasons.

First, test results are not necessarily easy to interpret. There are many other conditions which can mimic the symptoms of memory loss or dementia. Only trained medical staff can request further medical investigations which are necessary to establish and confirm a diagnosis.

Secondly, cognitive testing can be confronting and distressing for the person who is tested and psychological attention and counselling may be required. It is best to let a professional health-care worker handle this rather than putting yourself under the stress of dealing with a distressed loved one.

Last but not least, cognitive tests are susceptible to training effects, i.e. the more often you do the same test the better you perform. So chances are that if you administer the test to your family member at home, they might score negative (i.e., show no impairment) when assessed subsequently by a doctor due to training effects. This may delay the process of receiving a proper diagnosis and getting access to available support services. We ask you to refer to a doctor or other health care professional if you seek testing rather than administer any of these tests yourself.

Please consult the specifications and conditions of use in the section ‘Permissions & cost’ on each scale page. If you cannot find your intended use, please contact the original authors or publishers to seek permissions. The DOMS team is not able to authorise permission requests.
The DOMS website was originally developed for an Australian audience, while the current website is aimed at an international audience of health care professionals. You may consult our Australia-specific page for more information on the national guidelines for Australia and the scales with a specific relevance in Australian contexts. This includes information on a scale developed to assess cognitive impairment in Indigenous Australian populations.
The DOMS review is based on an in-depth assessment of the scientific literature and features scaled with sufficient evidence-based merit for the assessment of dementia. We do not feature clinical instruments upon request, but you are welcome to bring emerging evidence on existing or novel measures to our attention as we may use this in a future update to the site.

Advertisements or links to (commercial) services for clinicians or patients will not be featured on the DOMS website.