The "portable" CDR: translating the clinical dementia rating interview into a PDA format.

The Clinical Dementia Rating (CDR) is a common rating system used in clinical trials and longitudinal research projects to rate the presence and severity of cognitive problems in Alzheimer disease and related disorders. The interview process requires training and can be time-consuming. Here, we desc...

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Publicado en:Alzheimer Disease & Associated Disorders Vol. 23; no. 1; pp. 44 - 50
Autores principales: Galvin JE, Meuser TM, Coats MA, Bakal DA, Morris JC, Galvin, James E, Meuser, Thomas M, Coats, Mary A, Bakal, Donald A, Morris, John C
Formato: research Journal Article
Publicado: Lippincott Williams & Wilkins Jan-Mar2009
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Lippincott Williams & Wilkins
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        atl: The "portable" CDR: translating the clinical dementia rating interview into a PDA format.
      aug:
        au:
          Galvin JE
          Meuser TM
          Coats MA
          Bakal DA
          Morris JC
          Galvin, James E
          Meuser, Thomas M
          Coats, Mary A
          Bakal, Donald A
          Morris, John C
        affil: Alzheimer Disease Research Center, Washington University School of Medicine, 4488 ForestPark, Suite 130, St. Louis, MO 63108, USA
      sug:
        subj:
          Computers, Hand-Held
          Dementia Diagnosis
          Diagnosis, Computer Assisted Methods
          Severity of Illness Indices
          Algorithms
          Interviews Methods
          Reproducibility of Results
          Scales
          Software
          Human
      ab: The Clinical Dementia Rating (CDR) is a common rating system used in clinical trials and longitudinal research projects to rate the presence and severity of cognitive problems in Alzheimer disease and related disorders. The interview process requires training and can be time-consuming. Here, we describe the validity, reliability, and discriminative ability of a computer-generated CDR using a personal digital assistant format. This project used clinical data from 138 archival and live evaluations (patient and informant interviews) collected for research purposes at Washington University to develop and test a software-based system for the administration and automatic scoring of the CDR. The system was programmed for use on a hand-held computer via the Palm Operating System. We developed domain-specific algorithms to quantify and translate clinical scoring decisions for the 3 cognitive (Memory, Orientation, Judgment and Problem Solving) and the 3 functional (Community Affairs, Home and Hobbies, Personal Care) domains of the CDR. An acceptable set of algorithms were developed using data from 104 research cases, reflecting a range of impairment levels (CDR 0 to 3) and expert scoring decisions. These algorithms were then tested for accuracy in a validation sample of 34 cases. The computer-generated CDR has excellent internal consistency (Cronbach's alpha ranging from 0.94 to 0.98) and interrater reliability (intraclass correlation coefficient ranging from 0.88 to 0.96). The computer-generated CDR showed excellent discrimination between demented and nondemented cases (Area under the curve=0.95; 95% confidence interval, 0.84-1.1). The computer-generated CDR using a Palm Operating System is easy to use, valid, and reliable. The level of agreement compares favorably to published interrater reliability data for the CDR. Software-based administration and automatic scoring of the CDR is a viable alternative to paper-based methods and may be useful in research and clinical settings, especially where electronic data management and reliability in scoring are critical.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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