Inter-rater reliability of scales and tests used to measure mild cognitive impairment by general practitioners and psychologists.

BACKGROUND

This study was conducted to assess whether general practitioners (GPs) can be trained to use a simple battery of functional scales and neuropsychological tests to detect people likely to develop dementia as reliably as neuropsychologists in clinical practice.

METHODS

Fifty GPs with medium-sized practices in the Bordeaux area of France were recruited by monitors and trained to use a battery of tests (Mini-Mental State Examination (MMSE), Isaacs Set Test (IST), Benton Visual Retention Test (BVRT) and Zazzo's Cancellation Test (ZCT)). Each GP was required to recruit one patient. The tests were administered first by the GP,and then by a trained psychologist.

RESULTS

Overall, the GPs showed interest in participating in the study. They had no difficulty in recruiting patients according to the inclusion and exclusion criteria and none reported any difficulty in using the scales and tests battery. In total, 35 subjects were interviewed by both a trained GP and a psychologist. The scores obtained by the GPs and psychologists did not differ statistically for two of the four tests (IST, p = 0.6; BVRT, p = 0.7), but were statistically different for the other two tests (MMSE, p = 0.04; ZCT; p < 0.002).

CONCLUSIONS

The results confirm the feasibility of conducting a study for detecting cognitive deficit in general practice. The GPs were interested and participated well, patient adherence was good, and the concordance correlation coefficients between the GPs' and psychologists' scores were satisfactory.