<oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
  <dc:creator>Locatelli I</dc:creator>
  <dc:creator>Monod S</dc:creator>
  <dc:creator>Cornuz J</dc:creator>
  <dc:creator>Büla CJ</dc:creator>
  <dc:creator>Senn N</dc:creator>
  <dc:date>2017</dc:date>
  <dc:description xmlns:ns0="xml" ns0:lang="en">BACKGROUND
The present study takes place within a geriatric program, aiming at improving the diagnosis and management of geriatric syndromes in primary care. Within this program it was of prime importance to be able to rely on a robust and reproducible geriatric consultation to use as a gold standard for evaluating a primary care brief assessment tool. The specific objective of the present study was thus assessing the agreement and reliability of a comprehensive geriatric consultation.


METHOD
The study was conducted at the outpatient clinic of the Service of Geriatric Medicine, University of Lausanne, Switzerland. All community-dwelling older persons aged 70 years and above were eligible. Patients were excluded if they hadn't a primary care physician, they were unable to speak French, or they were already assessed by a geriatrician within the last 12 months. A set of 9 geriatricians evaluated 20 patients. Each patient was assessed twice within a 2-month delay. Geriatric consultations were based on a structured evaluation process, leading to rating the following geriatric conditions: functional, cognitive, visual, and hearing impairment, mood disorders, risk of fall, osteoporosis, malnutrition, and urinary incontinence. Reliability and agreement estimates on each of these items were obtained using a three-way Intraclass Correlation and a three-way Observed Disagreement index. The latter allowed a decomposition of overall disagreement into disagreements due to each source of error variability (visit, rater and random).


RESULTS
Agreement ranged between 0.62 and 0.85. For most domains, geriatrician-related error variability explained an important proportion of disagreement. Reliability ranged between 0 and 0.8. It was poor/moderate for visual impairment, malnutrition and risk of fall, and good/excellent for functional/cognitive/hearing impairment, osteoporosis, incontinence and mood disorders.


CONCLUSIONS
Six out of nine items of the geriatric consultation described in this study (functional/cognitive/hearing impairment, osteoporosis, incontinence and mood disorders) present a good to excellent reliability and can safely be used as a reference (gold standard) to evaluate the diagnostic performance of a primary care brief assessment tool. More objective/significant measures are needed to improve reliability of malnutrition, visual impairment, and risk of fall assessment before they can serve as a safe gold standard of a primary care tool.</dc:description>
  <dc:format>application/pdf</dc:format>
  <dc:identifier>https://sonar.ch/global/documents/266340</dc:identifier>
  <dc:language>eng</dc:language>
  <dc:relation>info:eu-repo/semantics/altIdentifier/doi/10.1186/s12877-017-0546-9</dc:relation>
  <dc:relation>info:eu-repo/semantics/altIdentifier/pmid/28724392</dc:relation>
  <dc:rights>info:eu-repo/semantics/openAccess</dc:rights>
  <dc:source>BMC geriatrics. - 2017</dc:source>
  <dc:subject xmlns:ns1="xml" ns1:lang="en">Agreement</dc:subject>
  <dc:subject xmlns:ns2="xml" ns2:lang="en">Geriatric consultation</dc:subject>
  <dc:subject xmlns:ns3="xml" ns3:lang="en">Intraclass correlation coefficient</dc:subject>
  <dc:subject xmlns:ns4="xml" ns4:lang="en">Kappa index</dc:subject>
  <dc:subject xmlns:ns5="xml" ns5:lang="en">Reliability</dc:subject>
  <dc:subject xmlns:ns6="xml" ns6:lang="en">Accidental Falls</dc:subject>
  <dc:subject xmlns:ns7="xml" ns7:lang="en">Aged</dc:subject>
  <dc:subject xmlns:ns8="xml" ns8:lang="en">Female</dc:subject>
  <dc:subject xmlns:ns9="xml" ns9:lang="en">Geriatric Assessment</dc:subject>
  <dc:subject xmlns:ns10="xml" ns10:lang="en">Geriatrics</dc:subject>
  <dc:subject xmlns:ns11="xml" ns11:lang="en">Humans</dc:subject>
  <dc:subject xmlns:ns12="xml" ns12:lang="en">Male</dc:subject>
  <dc:subject xmlns:ns13="xml" ns13:lang="en">Prospective Studies</dc:subject>
  <dc:subject xmlns:ns14="xml" ns14:lang="en">Referral and Consultation</dc:subject>
  <dc:subject xmlns:ns15="xml" ns15:lang="en">Reproducibility of Results</dc:subject>
  <dc:subject xmlns:ns16="xml" ns16:lang="en">Switzerland</dc:subject>
  <dc:title xmlns:ns17="xml" ns17:lang="en">A prospective study assessing agreement and reliability of a geriatric evaluation.</dc:title>
  <dc:type>http://purl.org/coar/resource_type/c_6501</dc:type>
</oai_dc:dc>