Inter-rater reliability of the Barthel ADL index: how does a researcher compare to a nurse?
OBJECTIVE
To investigate whether a nonclinical research assistant, using standardized scoring criteria, can reliably administer the Barthel Activities of Daily Living (ADL) Index in a sample of elderly inpatients.


METHODS
Paired comparison of nurse and nonclinical research assistant Barthel Index assessments.


METHODS
Acute hospital wards from two hospitals in a UK Healthcare Trust, with a catchment population of approximately 224,000 people.


METHODS
A consecutive sample of 94 elderly patients with a variety of medical problems.


METHODS
Barthel ADL Index, Folstein Mini-Mental Status Examination.


RESULTS
Whilst the inter-rater reliability of the Barthel Index was within acceptable boundaries, two items out of ten had only fair agreement and low crude agreement (transfer and dressing) on Cohen's kappa scores.


CONCLUSIONS
Depending on the differences observed in any particular context, the Barthel Index can be applied with reasonable reliability by nonclinical staff applying the standardized scoring criteria. It should be noted, however, that the kappa coefficients between clinical and nonclinical assessors tend to be lower than those found when comparing two clinically trained assessors in previous research.
Richards
S H
SH
Department of Social Medicine, University of Bristol, UK. suzanne.richards@bristol.ac.uk
Peters
T J
TJ
Coast
J
J
Gunnell
D J
DJ
Darlow
M A
MA
Pounsford
J
J
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009726:Nurses; D015588:Observer Variation; D012108:Research Personnel