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Other Measurement abstracts and tables:

Journal of Mental Health and Aging, Vol. 2, No. 3, 1996

Defining And Measuring Outcomes In Research On Alzheimer's Disease And Related Chronic Conditions: An Interdisciplinary Communication And Collaborative Challenge

Peter J. Whitehouse, MD, PhD

Abstract:  

This two-part special issue of the Journal of Mental Health and Aging provides an excellent review of measures used to assess individuals in chronic care settings. This work is timely as we seek to enrich our understanding of the how such individuals live their lives and whether our environments and programs satisfactorily address their needs and enhance their quality of life. In the later stages of dementia, such individuals, often are neglected by the broader research community. This special issue represents not just a summary of current approaches but a step in the evolution of our understanding of assessment including that of important noncognitive symptoms; such symptoms are perhaps more disabling than the purely cognitive symptoms, and frequently contribute to impairment in quality of life for both patient and caregivers.

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Alzheimer’s Disease and Associated Disorders, Vol. 8, Suppl. 1, pp. S291-S298

Abstract:  

Screening measures often are used to assess chronic care population, frequently in large multisite or multicenter studies. They are used to estimate prevalence in epidemiological surveys, identify risk factors for disease, identify cases and non-cases for research purposes, and target clinical, programmatic, and pharmacological interventions. For example, screening measures can be useful in identifying nursing home residents who might benefit from different types of dementia-specific special care. The cost of misclassification error varies according to use. A typical problem in screening is the high cost of false positives, persons who subsequently receive elaborate laboratory diagnostic measures based on erroneous screening results, or those allocated to additional and costly health services who can equally benefit from regular care. On the other hand, missing cases of certain types of illness can result in death or significant morbidity or excess disability. Those not identified might miss out on care that can be therapeutic. Thus, methods of minimizing misclassification errors are critical. This article presents some examples of the effects of item bias and discusses some models that can be used to maximize unbiased classifications. An unbiased indicator is one that behaves in the same manner (defined later) and is inferred to be measuring the same underlying attribute across comparison subgroups, and has the same valid-positive and false-positive rates (the same sensitivities and specificities) for each subgroup.

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Alzheimer’s Disease and Associated Disorders, Vol. 8, Suppl. 1, pp. S144-S183

Measurement Issues In Chronic Care Populations: Dementia Special Care

Abstract:  

This article reviews possible measurement problems in conducting research involving individuals with dementia and presents conceptual issues related to measurement of different domains and constructs as they relate to dementia care. Evaluation of dementia special care units (SCUs) poses special measurement problems that can affect the ability to determine the effectiveness of different types of care. Poor measurement will reduce the chances of detecting an intervention effect, if one exists. Paramount among these measurement problems are difficulties in assessing persons with severe cognitive deficits and problems in defining and measuring parameters of specialized care. Because little measurement research has been conducted with persons with dementia or in dementia SCUs, this article will draw heavily on what is known about measurement issues in other chronic care populations.

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Alzheimer Disease and Associated Disorders. An International Journal, Vol. 11, Suppl 6, Pp. 30-44

Abstract:  

This paper summarizes the measurement choices made by selected current or recently completed multi-site projects with a common emphasis on measuring outcomes in dementia. Information on number of items and scoring, reason(s) for selecting the measure, and reliability and validity of the measure (either citations providing this information or a report of pertinent unpublished findings) is presented for eight domains: cognition, behavioral symptoms, physical health status, physical functioning and self-care abilities, quality of life, family/staff caregiver outcomes, service use, and cost. We found considerable reliance on the published literature as a guide to measurement choice, motivated largely by measures’ superior psychometric properties, their ubiquity in the literature, and/or their brevity or ease of use. There is still evidence of "starting from scratch" in some domains, however. To the extent that these projects reflect the state of the art in dementia-relevant outcomes research, we conclude that comparison of outcomes across studies will continue to be problematic. However, as long as dissemination of methodological as well as substantive findings continues to characterize outcome studies in dementia, there is hope that a more congruent view of how to assess key outcomes in dementia will emerge.

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Journal of Mental Health and Aging, 1996, Vol. 2, No. 3, pp. 147-148

Measurement Of Older Chronic Care Populations

Jeanne A. Teresi, EdD, PhD

Abstract:  

This two-part special issue of the Journal of Mental and Aging contains reviews of measures that can be used in chronic care settings among individuals whose assessment is complicated because of factors, such as frailty, perceptual and communication problems, and advanced cognitive impairment.

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Journal of the American Geriatrics Society, 37, pp. 848-855

Abstract: 

  The Early Assessment Self Inventory (EASI) a rapid self-administered screening test for cognitive impairment in the elderly, was constructed to permit individuals to be assessed in a group or singly without examiner intervention. This paper-and-pencil device requires a fourth-grade reading level and makes minimal demands on literacy while assessing orientation, recent and remote memory, language, visual-construction, calculation, and attention. In the present study, EASI was group-administered to 146 elderly persons attending senior centers and completed individually without examiner intervention by 19 outpatients at a memory disorder clinic. Participants were 60 to 95 years old with 5 to 18 years of education. The EASI demonstrated good internal consistency and test-retest reliability and was significantly correlated with the Mini-Mental State Exam and the Mattis Dementia Rating Scale, both widely used screening instruments. Neuropsychological measures of memory, attention, and verbal fluency correlated as well with the EASI as with the examiner-administered screening instruments, suggesting that the EASI may provide an efficient method of screening for cognitive impairment.

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