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Differences in diagnosis for cognitive assessment following an in‐person physical examination versus a telegeriatric evaluation
Author(s) -
MartinKhan M.,
Varghese P.,
Wootton R.,
Gray L.
Publication year - 2009
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2009.05.272
Subject(s) - physical examination , dementia , telemedicine , medical diagnosis , face to face , medicine , kappa , psychology , telehealth , cohen's kappa , physical therapy , clinical psychology , psychiatry , health care , philosophy , linguistics , disease , epistemology , pathology , machine learning , computer science , economics , economic growth
which uses proxy or surrogate reports by carers or clinical informants of people with dementia. This presentation summarises the latest scientific literature and is designed to help busy clinicians and researchers ensure best practice when using proxy measurement. Methods: This presentation is based on a scientific literature review conducted as part of a project into developing a Dementia Outcomes Measurement Suite (Sansoni, et al. 2007) (Databases 1⁄4 PsycINFO, MEDLINE, CINAHL. Key search terms 1⁄4 proxy, informant, surrogate). Results: The review findings highlight the importance of using proxy measurement as a complementary piece of evidence. It is best used to assess objective constructs like physical functioning and behavior, rather than internal or subjective states like depression. Another key methodological issue is to describe usual rather than extreme behaviors. In addition, proxy ratings are subject to a number of biases and limitations (e.g. recall bias); and there is a need to develop practical ‘‘rules of thumb’’ for selecting proxy informants in different care settings. The health and cognitive status of carer proxies, as well as their level of caregiver burden, should also be assessed. Conclusions: Awareness of these basic issues when using proxy measurement for people with dementia should create greater accuracy in assessment, and thus improve health care monitoring, evaluation and research.