Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Manual Communication”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,135 records · Page 63Linked to original sources
PubMed1984

An assessment of the schedule for schizotypal personalities and the DSM-III criteria for diagnosing schizotypal personality disorder.

The authors assessed the reliability and validity of the DSM-III criteria for schizotypal personality disorder (SPD) and their measurement by the Schedule for Schizotypal Personalities (SSP) developed by Baron. Additional criteria not in DSM-III were also explored. Consensual clinical ratings of videotaped interviews of subjects were used to validate item content of the SSP and the schizotypal diagnosis. The SSP assessments, with the exception of odd speech, were found to be reliable and valid. Higher cutoff scores than those recommended by Baron may be helpful in discriminating schizotypal from other psychiatric patients. Six of eight DSM-III criteria and all experimental criteria were highly specific for SPD cases but varied widely in their sensitivities. Based on these pilot data, the authors recommend combining all of the criteria into four conceptual categories: 1) self-report cognitive-perceptual disturbances, 2) observable disorders of thought and communication, 3) deficits in drive or affect, and 4) interpersonal difficulties. When three of these were required to make the SPD diagnosis, all of the subjects in the present data set were correctly identified.

Affective Symptoms↗
PubMedDate not supplied

[A kibbutz group].

Kibbouts-group: three therapeutic or growth factors together: manual work, community life and group technics (group dynamic, Gestalt, psychodrama, bio-energetic) during two weeks. The work of growing and therapy is becoming more concrete and facilitated by the absence of difference between members and leader who share the work and the community life. Important and rapid changes are frequent: a particular attention is given to the "unmedicalisation" of symptoms (fatigue) and to the "unpsychiatrisation" of conflicts. A sample and authentical life style, together with a high degree of communication, favor the desinhibition of attitudes, the clarification of conflicts and the reenforcement of the personality.

Belgium↗
PubMed2002

Syndromic surveillance for bioterrorism following the attacks on the World Trade Center--New York City, 2001.

Immediately after the September 11, 2001, terrorist attacks on the World Trade Center (WTC), the New York City Department of Health and Mental Hygiene (NYCDOHMH) was concerned about the possibility of a secondary attack with a biologic agent. Because NYCDOHMH lost communications as a result of the attacks, concern arose that this disruption would affect the ability to recognize a bioterrorist event. To address this concern, NYCDOHMH quickly implemented a syndromic surveillance system in hospital emergency departments (EDs) to identify a large-scale bioterrorist event and other health conditions related to the WTC attacks. This report describes the operational and maintenance aspects of conducting syndromic surveillance for bioterrorism (BT) and demonstrates the limitations of drop-in systems that rely on manual data collection. Health departments that are establishing early warning systems for BT should consider seeking routinely collected electronic data.

Bioterrorism↗
PubMed1983

[Usefulness of dynamic computed tomography in the diagnosis of thoracic aortic aneurysms].

Five patients with thoracic aortic aneurysms, two saccular and three dissecting aneurysms, were examined by dynamic computed tomographic (CT) scanning. A Siemens Somatom 2 was employed. Dynamic scanning is the method by which plural serial images can be obtained in single operation. We used three serial images in a 5-second scan following a 3-second interval. After rapid manual injection of 30 ml of 76% megluminc amidotrizoate sodium into the right antecubital vein, scans of 4 mm section were performed three times and subsequently conventional scans four times. Serial changes in the same section and changes in the CT number against time in regions of interest in the image were investigated. Saccular aneurysms was difficult to distinguish from mediastinal tumors on the plain chest X-ray films. However, it was confirmed by the dynamic CT scanning demonstrating free communication between the aorta and the abnormal lumen, because the latter was filled with contrast medium, and the time of appearance, and the peak and washout of a contrast medium were almost the same between two lumens. In dissecting aneurysms, it was able to recognize both the false and true lumens as double channels in the aorta. We observed the different mode of dissection between the ascending and descending aorta in one case, and observed the twisting of an intimal flap in variable parts of the aorta in another case. Furthermore, it was possible to confirm the difference of blood flow pattern between the false and true lumens by dynamic CT. Because CT has a high quality image resolution, and especially, dynamic CT provides the serial changes in the same section after injection of contrast medium, both CT and dynamic CT are useful non-invasive imaging techniques for evaluating thoracic aortic aneurysms.

Adult↗
PubMed2003

A family-based approach to the prevention of depressive symptoms in children at risk: evidence of parental and child change.

OBJECTIVE: Depression in parents is a prevalent and impairing illness that is encountered frequently in medical practice. Children of depressed parents are at risk for psychopathology and other difficulties. A series of recent national reports have recommended the development of prevention efforts targeting children of depressed parents. Yet, to date, few controlled prevention studies of depression in children and adolescents have been conducted. In this study, we report the evaluation of 2 preventive intervention strategies that target children living in homes with depressed parents. Both are public health approaches that were designed to be used by a wide range of practitioners from a variety of disciplines, including pediatricians, internists, school counselors, nurses, and mental health practitioners. We adopted a developmental perspective and intervened with families when children were entering the age of highest risk for depression onset (ie, adolescence). We chose a family-based approach to prevention and sought to reduce risk factors and enhance protective factors for early adolescents by increasing positive interactions between parents and children, and by increasing understanding of the illness for everyone in the family. Our prevention approaches were designed to provide information about mood disorders to parents, to equip parents with the skills they need to communicate information to their children, and to open a dialogue with their children about the effects of parental depression. We hypothesized that participation in these prevention programs would result in parental change in child-related behaviors and attitudes about depression and its impact on the family. In addition, we hypothesized that this parental change would produce change in children's self-understanding, and in children's depressive symptomatology. METHODS: We conducted a large-scale efficacy trial of 2 manual-based preventive intervention programs that were designed to be used widely in public health settings. These interventions target the relatively healthy children (ages 8-15) of parents with mood disorder. Ninety-three families (88.5% of our initial sample), including 121 children, participated in this study through the fourth assessment point. These families were assigned randomly to either a lecture or a clinician-facilitated intervention. Both interventions were specified in manuals. The lecture condition consisted of 2 separate meetings delivered in a group format without children present. The clinician-facilitated condition consisted of 6 to 11 sessions, including separate meetings with parents and children, and a family meeting in which the parents led a discussion of the illness and of positive steps that can be taken to promote healthy functioning in the children. In addition, telephone contacts or refresher meetings were conducted at 6- to 9-month intervals. In both conditions, psychoeducational material about mood disorders, risk, and resilience was presented and efforts were made to decrease feelings of guilt and blame in children. Parents were helped to build resilience in their children through encouraging their friendships, their success outside of the home, and their understanding of parental illness and of themselves. In addition, in the clinician-facilitated condition, efforts were made to link the psychoeducational material presented to the family's own unique illness experience. To address directly how their lives had changed, all family members in both conditions were assessed for psychopathology and for overall functioning at intake, and for psychopathology, functioning, and response to intervention immediately postintervention, approximately 1 year postintervention, and again approximately 2.5 years postintervention. RESULTS: We examined the outcomes of child understanding and internalizing symptomatology, and a number of predictor variables, using repeated measures analyses with generalized estimating equations. We found that parents in both conditions reported significant change in child-related behaviors and and attitudes, and that the amount of change reported increased over time from time 3 to time 4 (chi2(1) = 18.1). Moreover, relative to parents in the lecture program (mean number of changes = 6.3), parents in the clinician-facilitated program reported more change in child-related behaviors and attitudes (mean number of changes = 9.8). Children in both conditions reported increased understanding of parental illness attributable to participation in our intervention programs. There was a positive association between the amount of change children reported in their understanding of parental illness and the number of changes couples reported in child-related behaviors/attitudes (chi2(1) = 37.3; ie, parents who had changed the most in response to intervention had children who also changed the most). Finally, internalizing scores for all children decreased with increased time since intervention (chi2(1) = 7.3). In addition, females had higher internalizing scores than males (chi2(1) = 5.3). There was no significant effect of group on children's change in internalizing symptomatology (chi2(1) = 0.2). CONCLUSIONS: We enrolled families with relatively healthy children, administered carefully designed preventive interventions that are manual-based and relatively brief, and found that these programs do have long-standing positive effects in how families problem solve around parental illness. Our results show significant benefits from both interventions. Moreover, changes in parents' perceptions translated directly into changes in children's own understanding of parental illness. Parental behavior and attitude changes and their connection to child changes in understanding identify an important mediating variable: family change. By increasing children's understanding of parental mood disorder, our interventions were found to promote resilience-related qualities in these children at risk. This presentation represents the first and only longitudinal primary prevention study of relatively healthy children at risk for psychopathology attributable to parental mood disorder and demonstrates a significant reduction in risk factors and increase in protective factors in these families over a long time interval--2(1/2) years. Our results provide support for a family-based approach to preventive intervention.

Adolescent↗
PubMed1999

Expanding DIOGENE with a clinical information system based on a new hospital-wide clinical finding dictionary.

The aim of this project is to expand DIOGENE with a centralized and integrated patient clinical database system providing a standardized framework for the building of future clinical databases and for the integration of existing heterogeneous ones. The combined 'across time view' and 'across departments view' generated from the integrated clinical data will enable an evolutionary view of the patient state both across time and across medical specialties. For this purpose and to permit the communication and exchange of data, a new controlled vocabulary for representing clinical data has been created. The construction of this vocabulary is based on the international ICD classification, already being used in DIOGENE for encoding patient diagnosis and procedures. A new extension of the ICD is proposed for medical information that goes beyond diagnosis and procedures encoding. The building of a common clinical finding dictionary recording the definition of findings is based on this newly developed clinical vocabulary. This process is incremental, manual, and significant.

Hospital Information Systems↗
PubMed2003

Knowledge and attitudes of gynecologists regarding genetic counseling for hereditary breast and ovarian cancer.

In a survey we investigated whether gynecologists are sufficiently knowledgeable to perform genetic counseling. It provides information for the development and evaluation of a counseling manual for professionals in primary health care. The members of the sample, consisting of 529 gynecologists in northern Germany, were mailed a questionnaire concerning their knowledge of and attitudes towards genetic counseling and testing for hereditary breast and ovarian cancer (HBOC). The response rate was 32.5% (n = 172). The majority of the respondents (82%) have received requests from patients for genetic testing. Most would offer basic genetic counseling to their patients, 66% feel knowledgeable enough to do so. Physicians set high value on communicating clinical management options, but also consider psychosocial aspects to be important. The results suggest that HBOC genetics play a noticeable role in the practice of gynecology in Germany. There is consensus about the need for further educational training to deal with cancer genetics in physicians' daily practice.

Adult↗
PubMed2000

Expanding DIOGENE with a clinical information system based on a new hospital-wide clinical findings dictionary.

The DIOGENE hospital information system has been expanded with a centralized and integrated patient clinical database recording structured patient data. The objective is to provide a standardized framework for the building of future clinical databases and for the integration of existing heterogeneous ones. The combined 'across time view' and 'across departments view' generated from the integrated clinical data will enable an evolutionary view of the patient state, both across time and across medical specialties. For this purpose and to permit the communication and exchange of data, a new controlled vocabulary for representing clinical data has been created. The construction of this vocabulary is based on the international ICD classification, already being used in DIOGENE for encoding patient diagnosis and procedures. A new extension of the ICD is proposed for medical information that goes beyond diagnosis and procedures encoding. The building of a common clinical findings dictionary, recording the definition of clinical entities, is based on this newly developed clinical vocabulary. This process is incremental, manual and substantial.

Decision Support Systems, Clinical↗
PubMed2005

[A documentation form for the consultation-liaison service: development of the CL-BaDo].

OBJECTIVES: In consultation liaison (CL) psychiatry and psychosomatics a multicenter documentation form for the assessment of clinical characteristics of patients and CL service delivery is urgently needed for health care planning and future mental health research. METHODS: In several steps a joint working party of the psychosomatic and psycho-therapeutic societies in Germany (German College for Psychosomatic Medicine, German Society of Psychosomatic Medicine and Psychotherapy, General Medical Society for Psychotherapy) developed a documentation form for C-L service (CL-BaDo). The goals and quality criteria of the patient registration form are defined in an extended consensus process of C-L experts. A pool of formerly 60 items was reduced to 36 items collecting data concerning sociodemographic characteristics, referral information, anamneses, actual psychiatric and somatic status and diagnoses, C-L interventions and treatment recommendations. To enable comparisons, the formulation of items are adapted to existing inpatient and outpatient documentation forms (Psy-BaDo,EuroQA-CL). A special manual guides the coding of the CL-BaDo. RESULTS: 16 CL services in Germany and Austria participated in the testing and pilot study of six months demonstrating the comprehensibility and fast completion of CL-BaDo and consultants' high acceptance of the form. A time-saving and user-friendly electronic version for data entry and data analyses was developed using hand-held technology. CONCLUSION: The data of the CL-BaDo can be used for 1) quality management and communication purposes with referring departments and 2) for multicenter collaborative studies, mental health care management and care planning.

Comorbidity↗
PubMed1993

Parietal lobe abnormalities detected with MR in patients with infantile autism.

OBJECTIVE: Infantile autism is a neurologic disorder that severely disrupts the development of many higher cognitive functions. The most consistent abnormal neuroanatomic findings in autism are loss of Purkinje neurons in the posterior cerebellum as detected by autopsy studies and hypoplasia of the posterior cerebellar vermis and hemispheres as detected by in vivo neuroimaging. Evidence of developmental arrest has also been detected in limbic structures in autopsy studies of autistic patients with mental retardation. Neither in vivo neuroimaging nor autopsy studies of autistic persons have reported abnormalities in the cerebrum. Because the cerebrum mediates many higher cognitive functions, such as social communication, language, abstract reasoning, planning, and organization, that are known to be deficient in patients with autism, a closer examination of the neuroanatomy of the cerebrum in infantile autism is warranted. MATERIALS AND METHODS: MR images of 21 healthy autistic patients (6-32 years old) were mixed with MR images of control subjects and reviewed on four separate occasions by a neuroradiologist for any neuroanatomic abnormalities. Autism was diagnosed on the basis of criteria for autism as defined by the Diagnostic and Statistical Manual of Mental Disorders, and the autistic patients did not have any other concurrent neurologic disorders. To control for systematic bias in judging the type and location of abnormalities in the autistic population, three control groups were used: a normal control group of 12 subjects, a control group of 23 nonautistic patients with a variety of brain abnormalities for the first review, and another control group of 17 nonautistic patients for the second review. Control patients with brain abnormalities were selected from patients' files on the basis of MR findings of a variety of brain abnormalities. All MR images were coded for anonymity, randomly mixed, and examined by a neuroradiologist blinded to the purpose of the study and to the group membership of each subject. All normal and abnormal findings seen on the MR images of each subject were described on a standard form listing all major brain structures to ensure an examination of each structure in turn. To test for reliability, three subsequent reviews were performed by the same neuroradiologist. RESULTS: Parietal lobes were abnormal in appearance in 43% (9/21) of autistic patients. Cortical volume loss in the parietal lobes was seen in seven autistic patients; in four of these cases, cortical volume loss extended either into the adjacent superior frontal or occipital lobe. Additional abnormalities detected with MR in these nine patients included white matter volume loss in the parietal lobes (three patients) and thinning of the corpus callosum, especially along the posterior body (two patients). Abnormalities were bilateral. The mesial, lateral, and orbital regions of the frontal lobes; temporal lobes; limbic structures; basal ganglia; diencephalon; and brainstem were normal in all autistic patients. No abnormalities were found in the 12 normal control subjects. The control subjects with neurologic abnormalities had various abnormal findings consistent with their medical conditions. CONCLUSION: Our results indicate that the parietal lobes are reduced in volume in a portion of the autistic population. Possible origins for this localized cerebral abnormality include early-onset altered development and late-onset progressive atrophy.

Adolescent↗
PubMed1975

Drug usage review in a community hospital.

A simple and effective manual drug usage review program in a community hospital is described. Fifteen randomly selected charts are screened each month by a drug information pharmacist. Charts demonstrating questionable drug therapy are forwarded to a physician member of the pharmacy and therapeutics committee; those showing questionable drug administration practices are referred to the nurse member of the committee. These committee members screen the questionable charts and refer to the entire committee those cases which require further follow-up. The committee categorizes the problems and communicates its recommendations to the individual practitioners involved. Recommendations focus on the legal ramifications of FDA-unapproved drug usage. During the first two years of the program, 341 charts were screened for drug usage; 62 of these were referred to the pharmacy and therapeutics committee for further review. In 20 cases, the committee sent a letter to the prescribing physician or his department chairman; in 16 cases, letters were sent to nursing administration.

Drug Utilization↗
PubMed2003

[Safety management in operating rooms].

In operating rooms, patients with a wide range of conditions are transferred from the wards to undergo surgery. Furthermore, because surgeons with different specialties perform various operations using instruments unique to their specialty, it is possible that operating room nurses, surgeons, and ward nurses do not always communicate clearly. Patients are anesthetized and unconscious, and as a general rule, family members are not allowed entry. As a result, operating rooms are unique environments where neither the patients receiving medical services nor their families can express opinions and concerns. Therefore an especially strict crisis management approach is needed in operating rooms. At present, individual hospital implement their own crisis management systems to prevent medical accidents. However, national debate is needed to establish medical accident prevention guidelines before each hospital compiles a manual that suits its needs.

Operating Rooms↗
PubMed2006

An ethno-medical perspective on research participation: a qualitative pilot study.

BACKGROUND: Recruitment of racial/ethnic minorities for clinical research continues to be problematic, yet critical to ensuring that research data will be applicable to diverse populations. There is a paucity of information about culturally appropriate methods for recruiting and retaining racial/ethnic minorities in research. OBJECTIVE: To cross-culturally assess perceptions of research participation by African American and immigrant Latinos living in the inner-city community of Watts, Los Angeles, California, using qualitative methods. DESIGN: Focus groups using ethnically matched moderators were convened with African American and immigrant Latino participants. Discussion was facilitated using a script that focused on perceived "feelings" and "perceptions" about research. Discussions were audiotaped, transcribed, and analyzed using manual and computerized statistically based software (mixed) methods. RESULTS: African Americans and immigrant Latinos shared several barriers and motivators to research. However, they also reported barriers and motivators to research that were distinct to each group. Latinos were more interested in healthcare and health information, and African Americans were more concerned with issues of trust and quality of care. Most participants said they would participate in research if they were better informed, or if they or a family member had an illness. Improving communication was reported as being important for motivating participation in clinical research. Overall, socioecologically and socioeconomically based domains were shared, whereas historically and/or socioculturally based domains were distinct. CONCLUSIONS: Using an ethno-medical science model, we demonstrated that it is possible to identify shared barriers and motivators to research participation between 2 distinct cultural groups. This approach can be useful in developing targeted community-based strategies to increase minority participation in clinical trials.

Adult↗
PubMed2005

Facial expression of emotions in borderline personality disorder and depression.

Borderline personality disorder (BPD) is characterized by marked problems in interpersonal relationships and emotion regulation. The assumption of emotional hyper-reactivity in BPD is tested regarding the facial expression of emotions, an aspect highly relevant for communication processes and a central feature of emotion regulation. Facial expressions of emotions are examined in a group of 30 female inpatients with BPD, 27 women with major depression and 30 non-patient female controls. Participants were videotaped while watching two short movie sequences, inducing either positive or negative emotions. Frequency of emotional facial expressions and intensity of happiness expressions were examined, using the Emotional Facial Action Coding System (EMFACS-7, Friesen & Ekman, EMFACS-7: Emotional Facial Action Coding System, Version 7. Unpublished manual, 1984). Group differences were analyzed for the negative and the positive mood-induction procedure separately. Results indicate that BPD patients reacted similar to depressed patients with reduced facial expressiveness to both films. The highest emotional facial activity to both films and most intense happiness expressions were displayed by the non-clinical control group. Current findings contradict the assumption of a general hyper-reactivity to emotional stimuli in patients with BPD.

Adult↗
PubMed2002

Information extraction for enhanced access to disease outbreak reports.

Document search is generally based on individual terms in the document. However, for collections within limited domains it is possible to provide more powerful access tools. This paper describes a system designed for collections of reports of infectious disease outbreaks. The system, Proteus-BIO, automatically creates a table of outbreaks, with each table entry linked to the document describing that outbreak; this makes it possible to use database operations such as selection and sorting to find relevant documents. Proteus-BIO consists of a Web crawler which gathers relevant documents; an information extraction engine which converts the individual outbreak events to a tabular database; and a database browser which provides access to the events and, through them, to the documents. The information extraction engine uses sets of patterns and word classes to extract the information about each event. Preparing these patterns and word classes has been a time-consuming manual operation in the past, but automated discovery tools now make this task significantly easier. A small study comparing the effectiveness of the tabular index with conventional Web search tools demonstrated that users can find substantially more documents in a given time period with Proteus-BIO.

Abstracting and Indexing↗
PubMedDate not supplied

Limitations of the scrape-loading/dye transfer technique to quantify inhibition of gap junctional intercellular communication.

Gap junctional intercellular communication (GJIC) is recognized as playing an important role in normal cell proliferation and development. Chemically induced alteration of GJIC has been proposed to be associated with abnormal cellular growth and/or tumor promotion. Several in vitro assays are currently used to determine the effects of chemicals on GJIC between cultured mammalian cells. One of these assays, the scrape-loading dye transfer (SL/DT) technique, is based on monitoring the transfer of the fluorescent dye Lucifer yellow from one cell into adjacent cells via functional gap junctions. The objective of our study was to evaluate and compare various approaches for quantifying results obtained with the SL/DT technique. Confluent cultures of either WB rat liver epithelial cells or LC-540 rat leydig cells were exposed to the animal tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA), solvent (0.1% ethanol), or culture medium for one hour at 37 degrees C prior to analysis of GJIC. Inhibition of dye transfer was clearly evident following TPA exposure. Quantification of this dye transfer was assessed via four approaches: manually counting the number of labeled cells; measuring the distance of dye travel from the scrape line; quantifying the amount of cellular dye uptake; and determining the distribution of dye away from the scrape line. Our results suggest that while the SL/DT technique can be effectively used as a tool to determine the qualitative presence or absence of GJIC, its use in quantifying changes in GJIC following chemical exposure is limited. Since concentration-dependent responses are critical in chemical testing, application of the SL/DT method should be restricted to a screening assay for qualitatively assessing the presence or absence of GJIC.

Animals↗
PubMed1989

Microcomputer-controlled administration of vasodilators following cardiac surgery: technical considerations.

Hypertension in the early postoperative period after cardiopulmonary bypass is associated with increased morbidity, and is commonly managed by the infusion of short-acting vasodilators. Automatic arterial blood pressure control by closed-loop infusion has been shown to be superior to manual control in several studies. The investigators have developed a closed-loop arterial pressure control system based on the Atari 1040ST microcomputer (Atari, Sunnyvale, CA). The program uses a proportional-integral-derivative control algorithm, developed from that described by Sheppard and his colleagues. The arterial waveform is sampled digitally, and the waveform analysis routine incorporates several artifact detection and rejection functions. Additional safety features are provided in the computer-infusion pump subroutine, which cause alarms to be activated if computer-pump communication fails to occur within a specified time period. A novel feature of this system is the clinical staff's use of a "mouse" to enter data and control the program, which makes keyboard skills unnecessary. This system is in routine service in the cardiac intensive care unit (CICU), both for direct clinical use and for research into various aspects of arterial pressure control, and has proved to be acceptable to the clinical staff.

Algorithms↗
PubMed2003

The validity and reliability of 6 sets of clinical criteria to classify Alzheimer's disease and vascular dementia in cases confirmed post-mortem: added value of a decision tree approach.

Data from 204 participants from the Oxford Project to Investigate Memory and Ageing, who were diagnosed post-mortem using the histopathological criteria of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), were used to assess the validity of the clinical criteria for Alzheimer's disease (AD) of the 'National Institute of Neurological and Communicative Disorders and Stroke/the Alzheimer's Disease and Related Disorders Association' (NINCDS/ADRDA). Cases who had been diagnosed as NINCDS/ADRDA 'probable AD' in life were usually confirmed at autopsy, but half of the NINCDS/ADRDA 'negative' cases were not (low specificity). It was hypothesized that the overall clinical impression may have taken precedence over the use of the actual criteria. We therefore investigated the validity and reliability of the clinical criteria using a computerized 'dementia diagnosis system' for each of 6 sets of criteria [Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), NINCDS/ADRDA and three sets of criteria specifically for vascular dementia (VaD): NINCDS-AIREN, State of California Alzheimer's Disease Diagnostic and Treatment Centers (ADDTC), and Vascular Cognitive Impairment (VCI)] to classify a subset (n = 96) of the cases confirmed post-mortem. The use of the computerized system significantly (p = 0.01) increased the specificity (81%, similar to sensitivity) of the NINCDS/ADRDA diagnoses, which were shown to have 'moderate' inter-rater reliability. The DSM-IV criteria had good validity for AD when compared with post-mortem confirmation and showed 'substantial' inter-rater reliability. The ADDTC and VCI criteria for VaD had good specificity (88%) and sensitivity (75%), but only for one rater. The DSM-IV and NINCDS-AIREN criteria for VaD showed poor validity and inter-rater reliability. We conclude that the forced use of decision trees through a computerized system enhances the accuracy of the clinical diagnoses of dementia.

Aged↗