Reliability of NINCDS-ADRDA clinical criteria for the diagnosis of Alzheimer's disease.
Although the NINCDS-ADRDA Work Group has recently developed uniform clinical criteria for the diagnosis of Alzheimer's disease (AD), inter-rater reliability studies of these criteria are few. We report a study in which 2 neurologists and 2 psychiatrists independently reviewed clinical data abstracted from the records of 30 demented subjects and 10 nondemented control subjects participating in a longitudinal study of AD at the University of Pittsburgh. We recorded the clinical data on a standardized form; the subjects' identity and clinical and pathologic diagnoses were omitted. Each physician diagnosed each case according to the NINCDS-ADRDA criteria. We calculated the inter-rater agreement for all possible 2-way combinations of clinicians with the Kappa statistic, which ranged from 0.36 (fair agreement) to 0.65 (substantial agreement). We conclude that current NINCDS-ADRDA criteria enable moderate levels of agreement among clinicians in general.
Lopez
O L
OL
Alzheimer Disease Research Center, University of Pittsburgh School of Medicine, PA 15213.
Swihart
A A
AA
Becker
J T
JT
Reinmuth
O M
OM
Reynolds
C F
CF
Rezek
D L
DL
Daly
F L
FL
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D015588:Observer Variation; D009938:Organizations; D014481:United States