title: Reliability and internal consistency of the Danish version of Loewenstein Occupational Therapy Cognitive Assessment 2nd Edition (LOTCA-II/D).
abstract: OBJECTIVE
  To evaluate the intra-rater and inter-rater reliability and internal consistency of the Danish version of the Loewenstein Occupational Therapy Cognitive Assessment, second edition (LOTCA-II/D), an instrument designed to assess and evaluate cognitive functioning.
  
  
  METHODS
  A reliability study was conducted at neurological acute care and rehabilitation units at three Danish hospitals. Fifty-four neurological patients participated in the study. Patients were tested with LOTCA-II/D by occupational therapists, and video recordings were made for reliability assessments. Intra-rater assessments were performed at least two weeks after the first assessment, and all occupational therapists were blinded to previous assessments. Intra-rater and inter-rater reliability were evaluated using percentage agreement and weighted kappa. Internal consistency was evaluated using Cronbach's alpha, and floor and ceiling effects were evaluated by calculating the proportion of observations in minimum and maximum categories of subtests.
  
  
  RESULTS
  The results showed a lack of intra-rater and inter-rater reliability and a large variation of agreement due to a substantial ceiling effect. Internal consistency was below the acceptable value in half of the cognitive areas.
  
  
  CONCLUSIONS
  The study found that LOTCA-II/D is not reliable in acute clinical practice, and it could thus not be validated for use in this setting.
authors.affiliation: Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Karina
authors.initials: K
authors.lastname: Lund
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Oestergaard
authors.forename: Thomas
authors.initials: T
authors.lastname: Maribo
mesh_terms: D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009788:Occupational Therapy / Q000379:methods*; D015203:Reproducibility of Results
keywords: Cognition; instrument; occupational therapy; rehabilitation; validity