Hendrie H C, Lane K A, Ogunniyi A, Baiyewu O, Gureje O, Evans R, Smith-Gamble V, Pettaway M, Unverzagt F W, Gao S, Hall K S
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Int Psychogeriatr. 2006 Dec;18(4):653-66. doi: 10.1017/S104161020500308X. Epub 2006 Apr 26.
Assessing function is a crucial element in the diagnosis of dementia. This information is usually obtained from key informants. However, reliable informants are not always available.
A 10-item semi-structured home interview (the CHIF, or Clinician Home-based Interview to assess Function) to assess function primarily by measuring instrumental activities of daily living directly was developed and tested for inter-rater reliability and validity as part of the Indianapolis-Ibadan dementia project. The primary validity measurements were correlations between scores on the CHIF and independently gathered scores on the Blessed Dementia Scale (from informants) and the Mini-mental State Examination (MMSE). Sensitivities and specificities of scores on the CHIF and receiver operator characteristic (ROC) curves were constructed with dementia as the dependent variable.
Inter-rater reliability for the CHIF was high (Pearson's correlation coefficient 0.99 in Indianapolis and 0.87 in Ibadan). Internal consistency, in both samples, was good (Cronbach's alpha 0.95 in Indianapolis and 0.83 in Ibadan). Scores on the CHIF correlated well with the Blessed Dementia scores at both sites (-0.71, p < 0.0001 for Indianapolis and -0.56, p < 0.0001 for Ibadan) and with the MMSE (0.75, p < 0.0001 for Indianapolis and 0.44, p < 0.0001 for Ibadan). For all items at both sites, the subjects without dementia performed significantly better than those with dementia. The area under the ROC curve for dementia diagnosis was 0.965 for Indianapolis and 0.925 for Ibadan.
The CHIF is a useful instrument to assess function directly in elderly participants in international studies, particularly in the absence of reliable informants.
评估功能是痴呆症诊断的关键要素。该信息通常从关键信息提供者处获取。然而，可靠的信息提供者并非总是可得。
作为印第安纳波利斯 - 伊巴丹痴呆症项目的一部分，开发了一项包含10个项目的半结构化居家访谈（CHIF，即临床医生居家访谈以评估功能），主要通过直接测量日常生活工具性活动来评估功能，并对其进行评分者间信度和效度测试。主要效度测量指标为CHIF得分与独立收集的Blessed痴呆量表（来自信息提供者）得分以及简易精神状态检查表（MMSE）得分之间的相关性。以痴呆症为因变量构建了CHIF得分的敏感性、特异性及受试者工作特征（ROC）曲线。
CHIF的评分者间信度较高（印第安纳波利斯的Pearson相关系数为0.99，伊巴丹为0.87）。两个样本的内部一致性均良好（印第安纳波利斯的Cronbach's alpha为0.95，伊巴丹为0.83）。CHIF得分在两个地点均与Blessed痴呆症得分显著相关（印第安纳波利斯为-0.71，p < 0.0001；伊巴丹为-0.56，p < 0.0001），也与MMSE得分相关（印第安纳波利斯为0.75，p < 0.0001；伊巴丹为0.44，p < 0.0001）。在两个地点的所有项目中，无痴呆症的受试者表现均显著优于患有痴呆症的受试者。印第安纳波利斯用于痴呆症诊断的ROC曲线下面积为0.965，伊巴丹为0.925。
CHIF是在国际研究中直接评估老年参与者功能的有用工具，特别是在缺乏可靠信息提供者的情况下。
