Diagnostic data for neurological conditions in interRAI assessments in home care, nursing home and mental health care settings: a validity study
Identifieur interne : 001602 ( Ncbi/Merge ); précédent : 001601; suivant : 001603Diagnostic data for neurological conditions in interRAI assessments in home care, nursing home and mental health care settings: a validity study
Auteurs : Andrea D. Foebel [Canada] ; John P. Hirdes [Canada] ; George A. Heckman [Canada] ; Marie-Jeanne Kergoat [Canada] ; Scott Patten [Canada] ; Ruth Ann Marrie [Canada]Source :
- BMC Health Services Research [ 1472-6963 ] ; 2013.
Abstract
The interRAI suite of assessment instruments can provide valuable information to support person-specific care planning across the continuum of care. Comprehensive clinical information is collected with these instruments, including disease diagnoses. In Canada, interRAI data holdings represent some of the largest repositories of clinical information in the country for persons with neurological conditions. This study examined the accuracy of the diagnostic information captured by interRAI instruments designed for use in the home care, long-term care and mental health care settings as compared with national administrative databases.
The interRAI assessments were matched with an inpatient hospital record and emergency department (ED) visit record in the preceding 90 days. Diagnoses captured on the interRAI instruments were compared to those recorded in either administrative record for each individual. Diagnostic validity was examined through sensitivity, specificity and positive predictive value analysis for the following conditions: multiple sclerosis, epilepsy, Alzheimer’s disease and other dementias, Parkinson’s disease, traumatic brain injury, stroke, diabetes mellitus, heart failure and reactive airway disease.
In the three large study samples (home care: n = 128,448; long-term care: n = 26,644; mental health: n = 13,812), interRAI diagnoses demonstrated high specificity when compared to administrative records, for both neurological conditions (range 0.80 – 1.00) and comparative chronic diseases (range 0.83 – 1.00). Sensitivity and positive predictive values (PPV) were more varied by specific diagnosis, with sensitivities and PPV for neurological conditions ranging from 0.23 to 0.94 and 0.14 to 0.77, respectively. The interRAI assessments routinely captured more cases of the diagnoses of interest than the administrative records.
The interRAI assessment collected accurate information about disease diagnoses when compared to administrative records within three months. Such information is likely relevant to day-to-day care in these three environments and can be used to inform care planning and resource allocation decisions.
Url:
DOI: 10.1186/1472-6963-13-457
PubMed: 24176093
PubMed Central: 3893477
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The interRAI suite of assessment instruments can provide valuable information to support person-specific care planning across the continuum of care. Comprehensive clinical information is collected with these instruments, including disease diagnoses. In Canada, interRAI data holdings represent some of the largest repositories of clinical information in the country for persons with neurological conditions. This study examined the accuracy of the diagnostic information captured by interRAI instruments designed for use in the home care, long-term care and mental health care settings as compared with national administrative databases.</p>
</sec>
<sec><title>Methods</title>
<p>The interRAI assessments were matched with an inpatient hospital record and emergency department (ED) visit record in the preceding 90 days. Diagnoses captured on the interRAI instruments were compared to those recorded in either administrative record for each individual. Diagnostic validity was examined through sensitivity, specificity and positive predictive value analysis for the following conditions: multiple sclerosis, epilepsy, Alzheimer’s disease and other dementias, Parkinson’s disease, traumatic brain injury, stroke, diabetes mellitus, heart failure and reactive airway disease.</p>
</sec>
<sec><title>Results</title>
<p>In the three large study samples (home care: n = 128,448; long-term care: n = 26,644; mental health: n = 13,812), interRAI diagnoses demonstrated high specificity when compared to administrative records, for both neurological conditions (range 0.80 – 1.00) and comparative chronic diseases (range 0.83 – 1.00). Sensitivity and positive predictive values (PPV) were more varied by specific diagnosis, with sensitivities and PPV for neurological conditions ranging from 0.23 to 0.94 and 0.14 to 0.77, respectively. The interRAI assessments routinely captured more cases of the diagnoses of interest than the administrative records.</p>
</sec>
<sec><title>Conclusions</title>
<p>The interRAI assessment collected accurate information about disease diagnoses when compared to administrative records within three months. Such information is likely relevant to day-to-day care in these three environments and can be used to inform care planning and resource allocation decisions.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article" xml:lang="en"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Health Serv Res</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Health Serv Res</journal-id>
<journal-title-group><journal-title>BMC Health Services Research</journal-title>
</journal-title-group>
<issn pub-type="epub">1472-6963</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24176093</article-id>
<article-id pub-id-type="pmc">3893477</article-id>
<article-id pub-id-type="publisher-id">1472-6963-13-457</article-id>
<article-id pub-id-type="doi">10.1186/1472-6963-13-457</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Diagnostic data for neurological conditions in interRAI assessments in home care, nursing home and mental health care settings: a validity study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Foebel</surname>
<given-names>Andrea D</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>adfoebel@uwaterloo.ca</email>
</contrib>
<contrib contrib-type="author" id="A2"><name><surname>Hirdes</surname>
<given-names>John P</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>hirdes@uwaterloo.ca</email>
</contrib>
<contrib contrib-type="author" id="A3"><name><surname>Heckman</surname>
<given-names>George A</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>ggheckman@uwaterloo.ca</email>
</contrib>
<contrib contrib-type="author" id="A4"><name><surname>Kergoat</surname>
<given-names>Marie-Jeanne</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>marie-jeanne.kergoat@umontreal.ca</email>
</contrib>
<contrib contrib-type="author" id="A5"><name><surname>Patten</surname>
<given-names>Scott</given-names>
</name>
<xref ref-type="aff" rid="I3">3</xref>
<email>patten@ucalgary.ca</email>
</contrib>
<contrib contrib-type="author" id="A6"><name><surname>Marrie</surname>
<given-names>Ruth Ann</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
<email>rmarrie@exchange.hsc.mb.ca</email>
</contrib>
<on-behalf-of>on behalf of the ideas PNC research team<xref ref-type="corresp" rid="d33e70"></xref>
</on-behalf-of>
</contrib-group>
<aff id="I1"><label>1</label>
School of Public Health & Health Systems, University of Waterloo, Waterloo, ON, Canada</aff>
<aff id="I2"><label>2</label>
Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada</aff>
<aff id="I3"><label>3</label>
Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada</aff>
<aff id="I4"><label>4</label>
Departments of Medicine and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada</aff>
<author-notes><corresp id="d33e70">on behalf of the ideas PNC research team</corresp>
</author-notes>
<pub-date pub-type="collection"><year>2013</year>
</pub-date>
<pub-date pub-type="epub"><day>1</day>
<month>11</month>
<year>2013</year>
</pub-date>
<volume>13</volume>
<fpage>457</fpage>
<lpage>457</lpage>
<history><date date-type="received"><day>25</day>
<month>10</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>28</day>
<month>10</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2013 Foebel et al.; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2013</copyright-year>
<copyright-holder>Foebel et al.; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<self-uri xlink:href="http://www.biomedcentral.com/1472-6963/13/457"></self-uri>
<abstract><sec><title>Background</title>
<p>The interRAI suite of assessment instruments can provide valuable information to support person-specific care planning across the continuum of care. Comprehensive clinical information is collected with these instruments, including disease diagnoses. In Canada, interRAI data holdings represent some of the largest repositories of clinical information in the country for persons with neurological conditions. This study examined the accuracy of the diagnostic information captured by interRAI instruments designed for use in the home care, long-term care and mental health care settings as compared with national administrative databases.</p>
</sec>
<sec><title>Methods</title>
<p>The interRAI assessments were matched with an inpatient hospital record and emergency department (ED) visit record in the preceding 90 days. Diagnoses captured on the interRAI instruments were compared to those recorded in either administrative record for each individual. Diagnostic validity was examined through sensitivity, specificity and positive predictive value analysis for the following conditions: multiple sclerosis, epilepsy, Alzheimer’s disease and other dementias, Parkinson’s disease, traumatic brain injury, stroke, diabetes mellitus, heart failure and reactive airway disease.</p>
</sec>
<sec><title>Results</title>
<p>In the three large study samples (home care: n = 128,448; long-term care: n = 26,644; mental health: n = 13,812), interRAI diagnoses demonstrated high specificity when compared to administrative records, for both neurological conditions (range 0.80 – 1.00) and comparative chronic diseases (range 0.83 – 1.00). Sensitivity and positive predictive values (PPV) were more varied by specific diagnosis, with sensitivities and PPV for neurological conditions ranging from 0.23 to 0.94 and 0.14 to 0.77, respectively. The interRAI assessments routinely captured more cases of the diagnoses of interest than the administrative records.</p>
</sec>
<sec><title>Conclusions</title>
<p>The interRAI assessment collected accurate information about disease diagnoses when compared to administrative records within three months. Such information is likely relevant to day-to-day care in these three environments and can be used to inform care planning and resource allocation decisions.</p>
</sec>
</abstract>
<kwd-group><kwd>Diagnostic validity</kwd>
<kwd>Nursing homes</kwd>
<kwd>Home care</kwd>
<kwd>Psychiatry</kwd>
<kwd>interRAI</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Canada</li>
</country>
<region><li>Alberta</li>
<li>Manitoba</li>
</region>
<settlement><li>Calgary</li>
<li>Winnipeg</li>
</settlement>
<orgName><li>Université de Calgary</li>
<li>Université du Manitoba</li>
</orgName>
</list>
<tree><country name="Canada"><noRegion><name sortKey="Foebel, Andrea D" sort="Foebel, Andrea D" uniqKey="Foebel A" first="Andrea D" last="Foebel">Andrea D. Foebel</name>
</noRegion>
<name sortKey="Heckman, George A" sort="Heckman, George A" uniqKey="Heckman G" first="George A" last="Heckman">George A. Heckman</name>
<name sortKey="Hirdes, John P" sort="Hirdes, John P" uniqKey="Hirdes J" first="John P" last="Hirdes">John P. Hirdes</name>
<name sortKey="Kergoat, Marie Jeanne" sort="Kergoat, Marie Jeanne" uniqKey="Kergoat M" first="Marie-Jeanne" last="Kergoat">Marie-Jeanne Kergoat</name>
<name sortKey="Marrie, Ruth Ann" sort="Marrie, Ruth Ann" uniqKey="Marrie R" first="Ruth Ann" last="Marrie">Ruth Ann Marrie</name>
<name sortKey="Patten, Scott" sort="Patten, Scott" uniqKey="Patten S" first="Scott" last="Patten">Scott Patten</name>
</country>
</tree>
</affiliations>
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