A prospective study assessing agreement and reliability of a geriatric evaluation.

Détails

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Etat: Public
Version: Final published version
ID Serval
serval:BIB_27042630EB9E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
A prospective study assessing agreement and reliability of a geriatric evaluation.
Périodique
BMC geriatrics
Auteur(s)
Locatelli I., Monod S., Cornuz J., Büla C.J., Senn N.
ISSN
1471-2318 (Electronic)
ISSN-L
1471-2318
Statut éditorial
Publié
Date de publication
19/07/2017
Peer-reviewed
Oui
Volume
17
Numéro
1
Pages
153
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
The present study takes place within a geriatric program, aiming at improving the diagnosis and management of geriatric syndromes in primary care. Within this program it was of prime importance to be able to rely on a robust and reproducible geriatric consultation to use as a gold standard for evaluating a primary care brief assessment tool. The specific objective of the present study was thus assessing the agreement and reliability of a comprehensive geriatric consultation.
The study was conducted at the outpatient clinic of the Service of Geriatric Medicine, University of Lausanne, Switzerland. All community-dwelling older persons aged 70 years and above were eligible. Patients were excluded if they hadn't a primary care physician, they were unable to speak French, or they were already assessed by a geriatrician within the last 12 months. A set of 9 geriatricians evaluated 20 patients. Each patient was assessed twice within a 2-month delay. Geriatric consultations were based on a structured evaluation process, leading to rating the following geriatric conditions: functional, cognitive, visual, and hearing impairment, mood disorders, risk of fall, osteoporosis, malnutrition, and urinary incontinence. Reliability and agreement estimates on each of these items were obtained using a three-way Intraclass Correlation and a three-way Observed Disagreement index. The latter allowed a decomposition of overall disagreement into disagreements due to each source of error variability (visit, rater and random).
Agreement ranged between 0.62 and 0.85. For most domains, geriatrician-related error variability explained an important proportion of disagreement. Reliability ranged between 0 and 0.8. It was poor/moderate for visual impairment, malnutrition and risk of fall, and good/excellent for functional/cognitive/hearing impairment, osteoporosis, incontinence and mood disorders.
Six out of nine items of the geriatric consultation described in this study (functional/cognitive/hearing impairment, osteoporosis, incontinence and mood disorders) present a good to excellent reliability and can safely be used as a reference (gold standard) to evaluate the diagnostic performance of a primary care brief assessment tool. More objective/significant measures are needed to improve reliability of malnutrition, visual impairment, and risk of fall assessment before they can serve as a safe gold standard of a primary care tool.

Mots-clé
Accidental Falls/prevention & control, Aged, Female, Geriatric Assessment/methods, Geriatrics/methods, Geriatrics/standards, Humans, Male, Prospective Studies, Referral and Consultation/standards, Reproducibility of Results, Switzerland/epidemiology, Agreement, Geriatric consultation, Intraclass correlation coefficient, Kappa index, Reliability
Pubmed
Web of science
Open Access
Oui
Création de la notice
03/08/2017 10:11
Dernière modification de la notice
20/08/2019 13:05
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