title: Agreement between instruments for rating treatment decisional capacity.
abstract: 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.
authors.affiliation: Mental Health Service, VA Boston Healthcare System, Harvard Medical School Department of Psychiatry, Boston, MA, USA. ronald.gurrera@va.gov
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Gurrera
authors.forename: Michele J
authors.initials: MJ
authors.lastname: Karel
authors.forename: Armin R
authors.initials: AR
authors.lastname: Azar
authors.forename: Jennifer
authors.initials: J
authors.lastname: Moye
mesh_terms: 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