Agreement between instruments for rating treatment decisional capacity.
OBJECTIVE
The objective of this study was to measure agreement between three treatment decisional capacity assessment instruments in mild to moderate dementia.


METHODS
Subjects (N=79) were recruited from the community. Rating agreement was evaluated with kappa statistics.


RESULTS
Three-way agreement was fair for overall capacity (kappa=0.451), very good for understanding (0.618), very poor for choice (0.158), and no better than chance for reasoning and appreciation. Pairwise agreement showed a similar pattern.


CONCLUSIONS
With the exception of understanding, current treatment decisional capacity assessment instruments do not consistently agree with one another in assessing treatment decision abilities.
Gurrera
Ronald J
RJ
Mental Health Service, VA Boston Healthcare System, Harvard Medical School Department of Psychiatry, Boston, MA, USA. ronald.gurrera@va.gov
Karel
Michele J
MJ
Azar
Armin R
AR
Moye
Jennifer
J
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology; D002755:Choice Behavior; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D032882:Comprehension; D003657:Decision Making; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D008403:Mass Screening; D016743:Mental Competency; D015588:Observer Variation; D015203:Reproducibility of Results; D013689:Telephone