Diagnosis of Alzheimer's disease in epidemiologic studies by staged review of clinical data.
We explored the inter-rater agreement and validity of diagnoses of Alzheimer disease (AD) and other dementias made in an epidemiological study.
A previously described protocol for cognitive screening and clinical assessment was applied to a large registry of twins.
An expert panel then reviewed results from the assessment of 41 subjects whose screening results suggested the presence of AD.
After review ofthe information at each of four stages ofdata collection, we assessed inter-rater agreement among the experts as well as their individual agreement with the final consensus diagnosis.
We investigated these measures to assess the amount and quality, respectively, of new and diagnostically useful information that was revealed at each stage.
A new scheme of weighted differences among the available diagnostic categories was developed for these analyses.
As expected, incremental information from successive stages of data collection enabled the panel to increase their diagnostic agreement and rates of « correct » diagnoses.
Over half of the total information was available, however, after review of only the initial telephone screening results (stage 1).
A brief standardized videotape segment of the mental status and neurologic examinations provided substantial additional information.
We were able to compare the final consensus diagnoses with autopsy results from seven individuals who had consensus clinical diagnoses of Probable or Possible AD (n=6) or demented, qu...
Mots-clés Pascal : Diagnostic, Jumeau, Accord interjuge, Validité, Epidémiologie, Vieillard, Homme, Démence Alzheimer, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Maladie dégénérative
Mots-clés Pascal anglais : Diagnosis, Twin, Interrater agreement, Validity, Epidemiology, Elderly, Human, Alzheimer disease, Nervous system diseases, Central nervous system disease, Cerebral disorder, Degenerative disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0184456
Code Inist : 002B18E. Création : 199608.