Application of Resource Utilization in Dementia (RUD) instrument in a global setting

Wimo, Anders; Gustavsson, Anders; Jönsson, Linus; Winblad, Bengt; Hsu, Ming‐Ann; Gannon, Brenda

doi:10.1016/j.jalz.2012.06.008

Cited by 148 publications

(153 citation statements)

References 26 publications

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“…In fact, there is evidence suggesting that informant report may be a better predictor of objective performance than self-report and may facilitate identification of very early decline related to AD (e.g., [44,47,48,51,52]). This may be particularly the case in advanced stages of preclinical AD in proximity to MCI [53]. In contrast, recent data suggest that earliest changes in cognition are best perceived by the individual rather than by an observer [54].…”

Section: Confirmation Of Cognitive Decline By Othersmentioning

confidence: 99%

A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease

Jessen

Amariglio

Boxtel

et al. 2014

Alzheimer's & Dementia

2,247

2,462

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There is increasing evidence that subjective cognitive decline (SCD) in individuals with unimpaired performance on cognitive tests may represent the first symptomatic manifestation of Alzheimer’s disease (AD). The research on SCD in early AD, however, is limited by the absence of common standards. The working group of the Subjective Cognitive Decline Initiative (SCD-I) addressed this deficiency by reaching consensus on terminology and on a conceptual framework for research on SCD in AD. In this publication, research criteria for SCD in pre-mild cognitive impairment (MCI) are presented. In addition, a list of core features proposed for reporting in SCD studies is provided, which will enable comparability of research across different settings. Finally, a set of features is presented, which in accordance with current knowledge, increases the likelihood of the presence of preclinical AD in individuals with SCD. This list is referred to as SCD plus.

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Section: Confirmation Of Cognitive Decline By Othersmentioning

confidence: 99%

A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease

Jessen

Amariglio

Boxtel

et al. 2014

Alzheimer's & Dementia

2,247

2,462

View full text Add to dashboard Cite

show abstract

“…This standardized instrument is widely used for resource use data collection in dementia, has been validated for use in different care settings (i.e., community-living and institutionalized patients) [20,21], and enables comparison of costs of care across countries with differing health care provisions [22]. The RUD instrument was administered via an interview with the primary informal caregiver.…”

Section: Resource Usementioning

confidence: 99%

What Drives Country Differences in Cost of Alzheimer’s Disease? An Explanation from Resource Use in the GERAS Study

Reed

Happich

Argimón³

et al. 2017

JAD

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Abstract.Background: Country differences in resource use and costs of Alzheimer's disease (AD) may be driven by differences in health care systems and resource availability. Objective: To compare country resource utilization drivers of societal costs for AD dementia over 18 months. Methods: GERAS is an observational study in France (n = 419), Germany (n = 550), and the UK (n = 526). Resource use of AD patients and caregivers contributing to >1% of total societal costs (year 2010) was assessed for country differences, adjusting for participant characteristics. Caregiver time spent on basic and instrumental activities of daily living (ADL) contributed the most to societal costs (54% France, 64% Germany, 65% UK). Caregivers in France spent less time on ADL than UK caregivers and missed fewer work days than in other countries. Compared with other countries, patients in France used more community care services overall and were more likely to use home aid. Patients in Germany were least likely to use temporary accommodation or to be institutionalized at 18 months. UK caregivers spent the most time on instrumental ADL, UK patients used fewest outpatient resources, and UK patients/caregivers were most likely to receive financial support. Conclusion: Caregiver time on ADL contributed the most to societal costs and differed across countries, possibly due to use of community care services and institutionalization. Other resources had different patterns of use across countries, reflecting country-specific health and social care systems.

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“…18–20 These instruments query respondents and their caregivers about the frequency of episodes of care, lengths of stay for hospitalizations or nursing facility care, and may also seek to identify specific dates, for example, of institutionalization. Some of these surveys also seek to quantify the cost of unpaid caregiving.…”

Section: Introductionmentioning

confidence: 99%

Errors in Self-Reports of Health Services Use

Callahan

Stump

et al. 2015

Alzheimer Disease &Amp; Associated Disorders

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Background Most Alzheimer's disease clinical trials that compare the use of health services rely on reports of caregivers. The goal of this study was to assess the accuracy of self-reports among older adults with Alzheimer's disease and their caregiver proxy respondents. This issue is particularly relevance to Alzheimer's disease clinical trials because inaccuracy can lead both to loss of power and increased bias in study outcomes. Methods We compared respondent accuracy in reporting any use and in reporting the frequency of use with actual utilization data as documented in a comprehensive database. We next simulated the impact of under-reporting and over-reporting on sample size estimates and treatment effect bias for clinical trials comparing utilization between experimental groups. Results Respondents self-reports have a poor level of accuracy with Kappa values often below 0.5. Respondents tend to under-report use even for rare events such as hospitalizations and nursing home stays. In analyses simulating under- and over-reporting of varying magnitude, we found that errors in self-reports can increase the required sample size by 15–30%. In addition, bias in the reported treatment effect ranged from 3%–18% due to both under-reporting and over-reporting errors. Conclusions Use of self-report data in clinical trials of Alzheimer's disease treatments may inflate sample size needs. . Even when adequate power is achieved by increasing sample size, reporting errors can result in a biased estimate of the true effect size of the intervention.

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Application of Resource Utilization in Dementia (RUD) instrument in a global setting

Abstract: Several minor changes were made to the RUD instrument to improve the accuracy and precision of the data while maintaining comparability with the original version and reflecting current medical practice. The RUD Complete Version 4.0 is now available for use in future AD clinical trials.

Cited by 148 publications

References 26 publications

A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease

A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease

What Drives Country Differences in Cost of Alzheimer’s Disease? An Explanation from Resource Use in the GERAS Study

Errors in Self-Reports of Health Services Use

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