A 78-year-old woman with advanced dementia (MRI shows cerebral atrophy) presents with baseline Mini-Cog score of 0/30. Her daughter reports progressive memory loss over 3 years despite donepezil therapy. Vital signs are stable (BP 138/82, HR 72, RR 16, Temp 98.6°F). Subsequent cognitive assessments at 3 and 6 months remain 0/30. No acute delirium is noted. Because the instrument cannot capture further deterioration below the minimum score, which measurement problem limits this study?

  1. A)Ceiling effect
  2. B)Spectrum bias
  3. C)Positive likelihood ratio
  4. D)Publication bias
  5. E)Floor effectGABARITO

Explicação

A floor effect occurs when many participants are clustered at the minimum possible score, leaving no room to detect further worsening. This makes the instrument insensitive among very impaired individuals. The test therefore lacks responsiveness at the low end... Ver explicação completa e trilha adaptativa →

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