Clinical criteria for the diagnosis of vascular dementia: A multicenter study of comparability and interrater reliability

Helena C. Chui, Wendy Mack, J. Edward Jackson, Daniel Mungas, Bruce R. Reed, Jured Tinklenberg, Fen-Lei Chang, Kate Skinner, Cora Tasaki, William J. Jagust

Research output: Contribution to journalArticle

193 Citations (Scopus)

Abstract

Background: Several clinical criteria have been developed to standardize the diagnosis of vascular dementia (VaD). Significant differences in patient classification have been reported, depending on the criteria used. Few studies have examined interrater reliability. Objective: To assess the concordance in classification and interrater reliability for the following 4 clinical definitions of VaD: the Hachinski Ischemic Score (HIS), the Alzheimer Disease Diagnostic and Treatment Centers (ADDTC), National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN), and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM- IV). Methods: Structured diagnostic checklists were developed for 4 criteria for VaD, 2 criteria for Alzheimer disease (AD), and 4 criteria for dementia. Twenty-five case vignettes, representing a spectrum of cognitive impairment and subtypes of dementia, were prepared in a standardized clinical format. Concordance in case classification using different criteria and interrater reliability among 7 ADDTCs given a specific set of criteria was assessed using the κ statistic. Results: The frequency of a diagnosis of VaD was highest using the modified HIS or DSM-IV criteria, intermediate using the original HIS and ADDTC criteria, and lowest using the NINDS-AIREN criteria. Scores for interrater reliability ranged from k = 0.30 (ADDTC) to k = 0.61 (original HIS). Conclusions: Clinical criteria for VaD are not interchangeable. Depending on the criteria selected, the reported prevalence of VaD will vary significantly. The traditional HIS has higher interrater reliability than the newer criteria for VaD. Prospective longitudinal studies with clinical-pathological correlation are needed to compare validity.

Original languageEnglish (US)
Pages (from-to)191-196
Number of pages6
JournalArchives of Neurology
Volume57
Issue number2
StatePublished - Feb 2000
Externally publishedYes

Fingerprint

Vascular Dementia
Multicenter Studies
National Institute of Neurological Disorders and Stroke
Diagnostic and Statistical Manual of Mental Disorders
Alzheimer Disease
Neurosciences
Dementia
Interrater Reliability
Checklist
Longitudinal Studies
Therapeutics
Prospective Studies

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Chui, H. C., Mack, W., Jackson, J. E., Mungas, D., Reed, B. R., Tinklenberg, J., ... Jagust, W. J. (2000). Clinical criteria for the diagnosis of vascular dementia: A multicenter study of comparability and interrater reliability. Archives of Neurology, 57(2), 191-196.

Clinical criteria for the diagnosis of vascular dementia : A multicenter study of comparability and interrater reliability. / Chui, Helena C.; Mack, Wendy; Jackson, J. Edward; Mungas, Daniel; Reed, Bruce R.; Tinklenberg, Jured; Chang, Fen-Lei; Skinner, Kate; Tasaki, Cora; Jagust, William J.

In: Archives of Neurology, Vol. 57, No. 2, 02.2000, p. 191-196.

Research output: Contribution to journalArticle

Chui, HC, Mack, W, Jackson, JE, Mungas, D, Reed, BR, Tinklenberg, J, Chang, F-L, Skinner, K, Tasaki, C & Jagust, WJ 2000, 'Clinical criteria for the diagnosis of vascular dementia: A multicenter study of comparability and interrater reliability', Archives of Neurology, vol. 57, no. 2, pp. 191-196.
Chui HC, Mack W, Jackson JE, Mungas D, Reed BR, Tinklenberg J et al. Clinical criteria for the diagnosis of vascular dementia: A multicenter study of comparability and interrater reliability. Archives of Neurology. 2000 Feb;57(2):191-196.
Chui, Helena C. ; Mack, Wendy ; Jackson, J. Edward ; Mungas, Daniel ; Reed, Bruce R. ; Tinklenberg, Jured ; Chang, Fen-Lei ; Skinner, Kate ; Tasaki, Cora ; Jagust, William J. / Clinical criteria for the diagnosis of vascular dementia : A multicenter study of comparability and interrater reliability. In: Archives of Neurology. 2000 ; Vol. 57, No. 2. pp. 191-196.
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abstract = "Background: Several clinical criteria have been developed to standardize the diagnosis of vascular dementia (VaD). Significant differences in patient classification have been reported, depending on the criteria used. Few studies have examined interrater reliability. Objective: To assess the concordance in classification and interrater reliability for the following 4 clinical definitions of VaD: the Hachinski Ischemic Score (HIS), the Alzheimer Disease Diagnostic and Treatment Centers (ADDTC), National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN), and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM- IV). Methods: Structured diagnostic checklists were developed for 4 criteria for VaD, 2 criteria for Alzheimer disease (AD), and 4 criteria for dementia. Twenty-five case vignettes, representing a spectrum of cognitive impairment and subtypes of dementia, were prepared in a standardized clinical format. Concordance in case classification using different criteria and interrater reliability among 7 ADDTCs given a specific set of criteria was assessed using the κ statistic. Results: The frequency of a diagnosis of VaD was highest using the modified HIS or DSM-IV criteria, intermediate using the original HIS and ADDTC criteria, and lowest using the NINDS-AIREN criteria. Scores for interrater reliability ranged from k = 0.30 (ADDTC) to k = 0.61 (original HIS). Conclusions: Clinical criteria for VaD are not interchangeable. Depending on the criteria selected, the reported prevalence of VaD will vary significantly. The traditional HIS has higher interrater reliability than the newer criteria for VaD. Prospective longitudinal studies with clinical-pathological correlation are needed to compare validity.",
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AU - Reed, Bruce R.

AU - Tinklenberg, Jured

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N2 - Background: Several clinical criteria have been developed to standardize the diagnosis of vascular dementia (VaD). Significant differences in patient classification have been reported, depending on the criteria used. Few studies have examined interrater reliability. Objective: To assess the concordance in classification and interrater reliability for the following 4 clinical definitions of VaD: the Hachinski Ischemic Score (HIS), the Alzheimer Disease Diagnostic and Treatment Centers (ADDTC), National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN), and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM- IV). Methods: Structured diagnostic checklists were developed for 4 criteria for VaD, 2 criteria for Alzheimer disease (AD), and 4 criteria for dementia. Twenty-five case vignettes, representing a spectrum of cognitive impairment and subtypes of dementia, were prepared in a standardized clinical format. Concordance in case classification using different criteria and interrater reliability among 7 ADDTCs given a specific set of criteria was assessed using the κ statistic. Results: The frequency of a diagnosis of VaD was highest using the modified HIS or DSM-IV criteria, intermediate using the original HIS and ADDTC criteria, and lowest using the NINDS-AIREN criteria. Scores for interrater reliability ranged from k = 0.30 (ADDTC) to k = 0.61 (original HIS). Conclusions: Clinical criteria for VaD are not interchangeable. Depending on the criteria selected, the reported prevalence of VaD will vary significantly. The traditional HIS has higher interrater reliability than the newer criteria for VaD. Prospective longitudinal studies with clinical-pathological correlation are needed to compare validity.

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