Reliability of the assessment of the clinical dementia rating scale from the analysis of medical records in comparison with the reference method.

IF 7.9 1区医学 Q1 CLINICAL NEUROLOGY Alzheimer's Research & Therapy Pub Date : 2024-09-05 DOI:10.1186/s13195-024-01567-9

Virginie Dauphinot, Sylvain Calvi, Claire Moutet, Jing Xie, Sophie Dautricourt, Anthony Batsavanis, Pierre Krolak-Salmon, Antoine Garnier-Crussard

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Abstract

Background: The Clinical Dementia Rating (CDR) scale allows to detect the presence of dementia and to assess its severity, however its evaluation requires a significant time (45 min). We evaluated the agreement between two methods of collection of the CDR: face-to-face interview or based on the information available in the patient's medical record.

Methods: The CLIMER study was conducted among patients attending a memory center. The CDR scale was evaluated during face-to-face interviews between neuropsychologists and patients and their caregivers and based on blind analysis of the information of the patients' medical record by neuropsychologists. The agreement of the CDR sum of boxes (CDR-SB), the 5-point scale CDR and the different domains of the CDR evaluated between the different methods was measured using intraclass correlation (ICC) coefficient, Bland and Altman method, and linearly weighted Kappa.

Results: The study included 139 patients (means ± SD age 80.1 ± 6, 58.3% women, 71.9% with dementia). The ICC for the CDR-SB score assessed by face-to-face and with all the information available in the patient's medical record was 0.95 (95% CI: 0.93-0.97). The mean difference between the CDR-SB score assessed by face-to-face and with the medical record was 0.098 ± 1.036, and 92.4% of the patients lay within the 95% limits of agreement. The ICC for the 5-point scale CDR assessed by face-to-face and with the patient's medical record was 0.92 (95% CI: 0.88-0.95) when all the available information of the patient's medical record was used. The linear weighted Kappa coefficients was 0.79 (95% CI: 0.68-0.91) for the 5-point scale CDR comparison between the two evaluation methods. The analysis by domain of the CDR showed ICC ranging from 0.65 to 0.91 depending of the domains and the methods of evaluation.

Conclusion: This study showed an excellent level of agreement of the evaluation of the CDR- SB and the 5-point scale CDR when using all the information of the patient's medical record compared to the face-to-face interview.

Trial registration: https//clinicaltrials.gov/ct2/show/NCT04763941 Registration Date 02/17/2021.

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从病历分析中评估临床痴呆评级量表的可靠性与参考方法的比较。

背景：临床痴呆评定量表（CDR）可以检测痴呆的存在并评估其严重程度，但其评估需要大量时间（45 分钟）。我们评估了两种临床痴呆评定量表收集方法之间的一致性：面对面访谈或基于患者病历中的信息：CLIMER研究在一家记忆中心的患者中进行。CDR量表是在神经心理学家与患者及其护理人员进行面对面访谈时以及在神经心理学家对患者病历信息进行盲法分析的基础上进行评估的。采用类内相关系数（ICC）、布兰德和阿尔特曼法以及线性加权卡帕法测量了不同方法评估的CDR方框总和（CDR-SB）、5点量表CDR以及CDR不同领域的一致性：研究包括 139 名患者（平均年龄（±SD）为 80.1±6 岁，58.3% 为女性，71.9% 为痴呆症患者）。根据患者病历中的所有信息，通过面对面评估 CDR-SB 得分的 ICC 为 0.95（95% CI：0.93-0.97）。面对面评估的 CDR-SB 得分与病历评估的 CDR-SB 得分之间的平均差异为 0.098 ± 1.036，92.4% 的患者在 95% 的一致性范围内。在使用患者病历中所有可用信息的情况下，通过面谈和病历评估的 5 分制 CDR 的 ICC 为 0.92（95% CI：0.88-0.95）。两种评估方法的 5 分 CDR 线性加权卡帕系数为 0.79（95% CI：0.68-0.91）。按 CDR 领域进行的分析表明，根据领域和评价方法的不同，ICC 在 0.65 至 0.91 之间：该研究表明，与面对面访谈相比，在使用患者病历的所有信息时，CDR- SB 和 5 点量表 CDR 的评价具有极高的一致性。试验注册：https//clinicaltrials.gov/ct2/show/NCT04763941 注册日期：02/17/2021。

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来源期刊

Alzheimer's Research & Therapy 医学-神经病学

CiteScore

13.10

自引率

3.30%

发文量

172

审稿时长

>12 weeks

期刊介绍： Alzheimer's Research & Therapy is an international peer-reviewed journal that focuses on translational research into Alzheimer's disease and other neurodegenerative diseases. It publishes open-access basic research, clinical trials, drug discovery and development studies, and epidemiologic studies. The journal also includes reviews, viewpoints, commentaries, debates, and reports. All articles published in Alzheimer's Research & Therapy are included in several reputable databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, MEDLINE, PubMed, PubMed Central, Science Citation Index Expanded (Web of Science) and Scopus.