Diagnostic data for neurological conditions in interRAI assessments in home care, nursing home and mental health care settings: a validity study

Abstract

BackgroundThe interRAI suite of assessment instruments can provide valuable information to support person-specific care planning across the continuum of care. Comprehensive clinical information is collected with these instruments, including disease diagnoses. In Canada, interRAI data holdings represent some of the largest repositories of clinical information in the country for persons with neurological conditions. This study examined the accuracy of the diagnostic information captured by interRAI instruments designed for use in the home care, long-term care and mental health care settings as compared with national administrative databases.MethodsThe interRAI assessments were matched with an inpatient hospital record and emergency department (ED) visit record in the preceding 90 days. Diagnoses captured on the interRAI instruments were compared to those recorded in either administrative record for each individual. Diagnostic validity was examined through sensitivity, specificity and positive predictive value analysis for the following conditions: multiple sclerosis, epilepsy, Alzheimer’s disease and other dementias, Parkinson’s disease, traumatic brain injury, stroke, diabetes mellitus, heart failure and reactive airway disease.ResultsIn the three large study samples (home care: n = 128,448; long-term care: n = 26,644; mental health: n = 13,812), interRAI diagnoses demonstrated high specificity when compared to administrative records, for both neurological conditions (range 0.80 – 1.00) and comparative chronic diseases (range 0.83 – 1.00). Sensitivity and positive predictive values (PPV) were more varied by specific diagnosis, with sensitivities and PPV for neurological conditions ranging from 0.23 to 0.94 and 0.14 to 0.77, respectively. The interRAI assessments routinely captured more cases of the diagnoses of interest than the administrative records.ConclusionsThe interRAI assessment collected accurate information about disease diagnoses when compared to administrative records within three months. Such information is likely relevant to day-to-day care in these three environments and can be used to inform care planning and resource allocation decisions.

Change in cognitive performance is associated with functional recovery during post-acute stroke rehabilitation: a multi-centric study from intermediate care geriatric rehabilitation units of Catalonia

“…Main strengths of our study include the multicenter design, leading to extensive data collection from a large, real and representative ). Moreover, the comprehensive assessment implemented in our setting is similar to the Minimum Data Set applied in other international contexts, such as nursing facilities in the United States, and to subsequent derived geriatric assessment tools [33], and includes a comprehensive assessment with validated cognitive and functional measures.…”

Clinical Predictors of Delayed Discharges in Inpatient Mental Health Settings Across Ontario

“…risk of harm. The reliability and validity of the RAI-MH have been previously established in a variety of studies (Foebel et al 2013; Gibbons et al 2008; Hirdes et al 2008; Jones et al 2010; Martin et al 2009). …”

Characteristics and Incidence of Traumatic Brain Injury in Older Adults Using Home Care in Ontario from 2003–2013

“…Any text diagnoses in this section that referred to head trauma, concussion, closed head injury, head injury, or acquired brain injury was used to capture cases of TBI. This method of capturing TBI (i.e., item and text entries) has been previously validated; (23) it had a sensitivity of 0.23, a specificity of 0.99, a positive predictive value of 0.22, and a kappa statistic of 0.22 when compared to linked data from the National Ambulatory Care Reporting System (NACRS) and the Canadian Institute for Health Information (CIHI). (24) …”

“…(15) Foebel and colleagues (23) found that the validity of items related to diagnoses of Alzheimer’s disease and other dementia (sensitivity of 0.76; specificity of 0.89; PPV of 0.53; kappa statistic of 0.55), parkinsonism (sensitivity of 0.83; specificity of 0.98; PPV of 0.59; kappa statistic of 0.68), and multiple sclerosis (sensitivity of 0.90; specificity of 1.00; PPV of 0.77; kappa statistic of 0.83) was acceptable when compared to linked NACRS and CIHI data. (24) …”