title: Inter-Rater Agreement in the Clinical Diagnosis of Cognitive Status: Data from the Neurological Disorders in Central Spain 2 Pilot Study.
abstract: To assess the diagnostic agreement of cognitive status (dementia, mild cognitive impairment (MCI), normal cognition) among neurologists in the field of neurological disorders in Central Spain 2 study.
  
  
  
  Full medical histories of 30 individuals were provided to 27 neurologists: 9 seniors, 10 juniors and 8 residents. For each case, we were asked to assign a diagnosis of dementia, MCI or normal cognition using the National Institute on Aging-Alzheimer's Association workgroup (NIA-AA) core clinical criteria for all-cause dementia, Winblad et al. criteria for MCI, and analyze intensity and etiology if dementia was diagnosed. Inter-rater agreement was assessed both with percent concordance and non-weighted κ statistics.
  
  
  
  Overall inter-rater agreement on cognitive status was κ = 0.76 (95% CI 0.65-0.86), being slightly higher among junior neurologists (κ = 0.85, 95% CI 0.73-0.95) than among seniors (κ = 0.71, 95% CI 0.59-0.83) and residents (κ = 0.69, 95% CI 0.54-0.81) but without statistical significance among groups. Dementia severity showed an overall κ of 0.34, 0.44 and 0.64 for mild, moderate and severe dementia respectively.
  
  
  
  Substantial agreement was demonstrated for the diagnosis of cognitive status (dementia, MCI and normal cognition) among neurologists of different levels of experience in a population-based epidemiological study using NIA-AA and Winblad et al.
  
  
  
  The agreement rate was lower in the diagnosis of dementia severity.
authors.affiliation: Department of Neurology, Hospital Universitario '12 de Octubre', Madrid, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Llamas-Velasco
authors.forename: Fernando
authors.initials: F
authors.lastname: Sierra-Hidalgo
authors.forename: Lucia
authors.initials: L
authors.lastname: Llorente-Ayuso
authors.forename: Alejandro
authors.initials: A
authors.lastname: Herrero-San Martín
authors.forename: Alberto
authors.initials: A
authors.lastname: Villarejo Galende
authors.forename: Félix
authors.initials: F
authors.lastname: Bermejo Pareja
mesh_terms: D060825:Cognitive Dysfunction / Q000175:diagnosis*; D003704:Dementia / Q000175:diagnosis*; D006801:Humans; D000072141:Neurologists; D015588:Observer Variation; D015203:Reproducibility of Results; D013030:Spain