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Interrater reliability of the Clinical Dementia Rating in a multicenter trial
K Rockwood1, D Strang, C MacKnight
1Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Objective:
To test the interrater reliability of the Clinical Dementia Rating (CDR) in a multicenter clinical trial.
Design:
Observational study.
Setting:
Training session for a multicenter trial of milameline, a direct muscarinic agonist, in the treatment of Alzheimer's disease.
Participants:
Twenty-four raters (physicians and nurses) familiar with drug trials and expert in the care of patients with Alzheimer's disease.
Methods:
Independent scoring of the CDR using four videotaped CDR interviews.
Outcome Measure:
Interrater reliability, as tested by the Kappa statistic
Results:
The overall interrater reliability was 0.62. Within the CDR domains, the global kappas ranged from 0.33 +/- 0.06 to 0.88 +/- 0.06.
Conclusions:
The data support moderate to high overall interrater reliability but show important difficulties in the reliable assessment of early dementia.