치매에 대한 어느 역학적 연구에서 진단의 일치도

Diagnostic Agreement between Two Diagnosticians in a Community Study of Dementia

Diagnostic agreement of dementia between two diagnosticians was studied. In Study 1 (1 1 = 94), the subjects were conjointly assessed by two psychiatrists regarding cognitive status, neurological and physical status and medical conditions. Interviews with the next of kin were conducted to obtain informations about cognitive decline, past medical and psychiatric histories, and alcohol and drug use problems. In Study 2 ( n = 8 3 ), one psychiatrist collected all the data about the subjects, and another psychiatrist was allowed to use only the data of cognitive status in diagnosing them. DSM-III-R was employed as the criteria for dementia. Questionable dementia was introduced to diagnose subjects whose cognitive impairment was insufficient to diagnose dementia. Diagnostic categories were either dementia, questionable dementia or nondementia. In the estimation of diagnostic agreement questionable dementia was considered as nondementia at one time and as dementia at another time, k values were 0.845 to 0.915 in Study 1, and 0.618 to 0.766 in Study 2. k increased when questionable dementia was considered as dementia. Findings of the present study may suggest that diagnostic accuracy was high in the previous epidemiological studies of authors