The Barthel ADL Index: Scoring by the Physician from Patient Interview is not Reliable

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Abstract
Using the Barthel index, a physician's ADL scoring based upon clinical interviews of 59 elderly nursing-home patients was compared with the scoring by nurses based upon observations over time (the reference method). The scoring by the doctor was higher than that by the nurses (mean score 14.3 vs 12.2), and especially so in the subgroup of patients with a low score on the Mini-Mental Status (mean score 15.4 vs 11.1). Use of the kappa statistics on each item of the Barthel ADL index showed that, in general, the agreement was poor between physician's scoring and the reference method. However, information collected by the physician on Barthel index items reflecting mobility demonstrated fair to good agreement among patients with a higher score on the Mini-Mental Status.

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