Agreement between instruments for rating treatment decisional capacity

Am J Geriatr Psychiatry. 2007 Feb;15(2):168-73. doi: 10.1097/JGP.0b013e31802e705c.


Objective: The objective of this study was to measure agreement between three treatment decisional capacity assessment instruments in mild to moderate dementia.

Method: Subjects (N=79) were recruited from the community. Rating agreement was evaluated with kappa statistics.

Results: Three-way agreement was fair for overall capacity (kappa=0.451), very good for understanding (0.618), very poor for choice (0.158), and no better than chance for reasoning and appreciation. Pairwise agreement showed a similar pattern.

Conclusions: With the exception of understanding, current treatment decisional capacity assessment instruments do not consistently agree with one another in assessing treatment decision abilities.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / psychology
  • Choice Behavior
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / psychology
  • Comprehension
  • Decision Making*
  • Female
  • Humans
  • Informed Consent*
  • Male
  • Mass Screening
  • Mental Competency*
  • Observer Variation
  • Reproducibility of Results
  • Telephone