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Medicine Science

Copyright Claim Sets Back Cognitive Impairment Testing 116

Kilrah_il writes "A recent New England Journal of Medicine editorial talks about the mini-mental state examination — a standardized screening test for cognitive impairment. After years of being widely used, the original authors claim to own copyright on the test and 'a licensed version of the MMSE can now be purchased [...] for $1.23 per test. The MMSE form is gradually disappearing from textbooks, Web sites, and clinical tool kits.' The article goes on to describe the working of copyright law and various alternative licenses, including GNU Free Documentation License, and ends with the following suggestion: 'We suggest that authors of widely used clinical tools provide explicit permissive licensing, ideally with a form of copyleft. Any new tool developed with public funds should be required to use a copyleft or similar license to guarantee the freedom to distribute and improve it, similar to the requirement for open-access publication of research funded by the National Institutes of Health.'"
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Copyright Claim Sets Back Cognitive Impairment Testing

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  • by Nemesisghost ( 1720424 ) on Friday December 30, 2011 @09:53AM (#38538174)
    I sincerely hope that all of the authors either have a stroke, Alzheimer's, or some other disease that impairs mental faculty and the attending doctor doesn't know how to perform this test due to their idiotic copyright enforcement.
  • by Mathinker ( 909784 ) on Friday December 30, 2011 @10:03AM (#38538244) Journal

    The authors were letting everyone download the new test for free; a corporation, PAR [parinc.com], to which the old test had been licensed is to blame for claiming copyright over (elements of) the new test which may eventually replace the old one.

    Unfortunately, there's no easy way to leave them a comment about one's opinion of their behavior on their website. I looked.

  • Re:Public Funds (Score:4, Informative)

    by Anonymous Coward on Friday December 30, 2011 @10:03AM (#38538248)

    Do you have any evidence this test was developed using public funds? I honestly don't know, but Wikipedia says it was developed by Marshal F. Folstein, Susan Folstein, and Paul R. McHugh in 1975. McHugh is the only author with his own Wikipedia page (and I'm too lazy to do further research), but in 1975 he worked for Johns Hopkins University, which is a private university.

  • by pla ( 258480 ) on Friday December 30, 2011 @10:24AM (#38538468) Journal
    Unfortunately, there's no easy way to leave them a comment about one's opinion of their behavior on their website. I looked.

    You could try cs@parinc.com, their customer service email address.

    You could also try rsmith@parinc.com, their CEO.

    That said, pond scum doesn't usually care what you think about it.
  • by Mathinker ( 909784 ) on Friday December 30, 2011 @11:07AM (#38538952) Journal

    > We'll have to see if the authors' new version is actually copyright infringement on the old one.

    I'm sorry to have confused the discussion here by emphasizing something not mentioned in the summary and only in the linked article. It's actually two tests from two different sets of authors. The newer test is called "The Sweet 16" (what a terrible name) and as far as anyone can tell (the newer test is unavailable, even in this era of the Internet, AFAIK), it is unlikely that any claim of infringement is valid.

    I just hope some clinician who managed to download the newer test, in the few weeks it actually was available, will have the good idea to ask a favor from a friend who knows how to anonymously publish information on the net.

  • Re:not First Post (Score:4, Informative)

    by Mordok-DestroyerOfWo ( 1000167 ) on Friday December 30, 2011 @11:08AM (#38538956)

    That's fine. I won't quote you and I'll compose my own post.

    With blackjack and hookers!

  • Re:Sweet 16 vs MMSE (Score:5, Informative)

    by urulokion ( 597607 ) on Friday December 30, 2011 @11:35AM (#38539246)

    No you can't copyright logic. Nor can you copyright a thought. Nor can you copyright a plot. Copyright protects the expression of logic, thoughts, plots, et. al. So you can't copyright a plot, but you can copyright a screenplay which is an expression of a plot. You can't a thought, you can copyright a poem which expresses that thought. And you can't copyright the idea of a way to testing cognitive functioning, but you can copyright a standardized test to test cognitive functioning

    The only way the Sweet 16 test could me infringing is if it's a derivative of the MMSE test. And I would suspect the creator of the Sweet 16 explicitly avoided that particular trap. It sounds like she created her own test using the general methodology used by the MMSE. Hmmm. Why does that sounds familiar...protection of methodology? Because that's the realm of patents. That's the only thing that the Sweet 16 test could be infringing. But any possible patent protection for the MMSE test has long since expired.

  • by John Newman ( 444192 ) on Friday December 30, 2011 @12:26PM (#38539890)

    I'm one of the authors on the NEJM article.

    The developers of the Sweet 16 - the test apparently "taken down" for copyright infringement of the MMSE - were all Harvard faculty, and work for academic centers that are affiliated with Harvard and its hospitals (Hospital Elder Life Program, Institute for Aging Research and Hebrew Senior Life). The senior author of the Sweet 16 is a well-known Harvard professor [hebrewseniorlife.org]. One of the things we find concerning about this case is that Harvard Medical School probably has some claim to ownership of the Sweet 16, and was presumably involved in its defense. If Harvard, with its vast resources, could not or chose not to defend the Sweet 16 successfully, what hope do any other researchers have to develop new cognitive testing tools?

  • Re:Sweet 16 vs MMSE (Score:5, Informative)

    by John Newman ( 444192 ) on Friday December 30, 2011 @12:40PM (#38540092)

    I'm one of the authors of the NEJM article.

    We didn't have the space to describe the MMSE and Sweet 16 in detail, but here's a brief description:

    The MMSE has 30 items, which include 10 orientation questions (what's today's date, where are we, etc.) and 6 questions for recall (say 3 standard words, repeat them back and remember them for 5 minutes or so).

    The Sweet 16 has 16 items which include 8 orientation questions and 6 questions for recall (using different words than the MMSE). The other two questions involve repeating a sequence of numbers backwards.

    So there is a lot of overlap between the two tests, and that was presumably the basis for an infringement claim. However, the items that overlap - orientation and recall - are quite generic and were in wide use long before the MMSE was created in 1975. Nevertheless, the authors behind Sweet 16 and their institution could not or chose not to defend the Sweet 16.

    It's a little hard to imagine a cognitive assessment tool that doesn't include orientation or short-term memory recall questions, so this will strongly discourage progress in the field. Perhaps one of the Alzheimer's advocacy groups will take notice and defend researchers trying to advance the state of the art.

  • Re:Apologies (Score:5, Informative)

    by John Newman ( 444192 ) on Friday December 30, 2011 @01:13PM (#38540452)

    Sorry, I didn't see that the summary incorrectly states that the authors of the older test were claiming infringement. AFAIK, they're not.

    I guess I failed the comprehension test. Actually, I didn't really read the summary carefully, since I was already familiar with the actual facts.

    I am one of the authors of the NEJM op/ed article.

    It is all a little confusing. There are three parties here:
    1. The original authors of the MMSE, who through PAR are strictly enforcing copyright protections of the MMSE
    2. The authors of a new tool, the Sweet 16, which was created as an open-access alternative to the MMSE but was "taken down" by PAR in a copyright dispute
    3. Us, the authors of TFA, who have no relationship to #1 or #2 but are very worried about what this all means for the practice and progress of medicine

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