Computer-assisted assessment of depression and function in older primary care patients.
We wanted to test the psychometric reliability and validity of self-reported information on psychological and functional status gathered by computer in a sample of primary care outpatients. Persons aged 65 years and older visiting a primary care medical practice in Baltimore (n=240) were approached. Complete baseline data were obtained for 54 patients and 34 patients completed 1-week retest follow-up. Standard instruments were administered by computer and also given as paper and pencil tests. Test-retest reliability estimates were calculated and comparisons across mode of administration were made. Separately, an interviewer administered a questionnaire to gauge patient attitudes and feelings after using the computer. Most participants (72%) reported no previous computer use. Nevertheless, inter-method reliability of the GDS15 at baseline (0.719, n=47), intra-method reliability of the computer in time (0.797, n=31), inter-method reliability of the CESDR20 at baseline (0.740, n=53), and the correlation between the CESDR20 computer version at baseline and follow-up (0.849, n=34) were all excellent. The inter-method reliability of the CESDR20 at follow-up (0.615, n=37) was lower but still acceptable. Although 28% were anxious prior to using the computer testing system, that percent decreased to 19% while using the system. The efficiency and reliability in comparison to the paper instruments were good or better. Even though most participants had not ever used a computer prior to participating in the study, they had generally favorable attitudes toward the use of computers, and also reported having favorable experience with the computer testing system.
Kurt
Reyis
R
Department of Family Medicine, Universitair Medisch Centrum St. Radboud, Katholieke Universiteit Nijmegen, Nijmegen, The Netherlands.
Bogner
Hillary R
HR
Straton
Joseph B
JB
Tien
Allen Y
AY
Gallo
Joseph J
JJ
D017677:Age Distribution; D000368:Aged; D015142:Baltimore; D003863:Depression / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted; D015577:Geriatric Assessment / Q000379:methods*; D006786:Hospitals, Urban; D006801:Humans; D011320:Primary Health Care / Q000379:methods*; D011594:Psychometrics; D015203:Reproducibility of Results; D012984:Software; D011795:Surveys and Questionnaires