A randomized trial of a decisional aid for mental capacity assessments

Naglie, Gary; Silberfeld, Michel; O’Rourke, Keith; Fried, Bruce J.; Corber, Wendy; Bombardier, Claire; Detsky, Allan S.

doi:10.1016/0895-4356(93)90069-d

Cited by 13 publications

(17 citation statements)

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“…Consensus of expert rater outcomes have generally shown good overall agreement. 16,[19][20][21][22] To ensure that the experts focused only on the capacity data and that performance on measures of cognition did not influence their capacity judgments, raters were blinded to all clinical data that characterized cognitive, functional, and PD symptom-related severity.…”

Section: Methods Study Participants and Eligibility Criteriamentioning

confidence: 99%

Cognitive impairment and PD patients' capacity to consent to research

et al. 2013

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Section: Methods Study Participants and Eligibility Criteriamentioning

confidence: 99%

Cognitive impairment and PD patients' capacity to consent to research

et al. 2013

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“…To identify overall agreement with the psychiatric assessment, the receiver-operating curve (ROC) was calculated. Data were analysed following the cut-off scores of the MMSE and Silberfeld scores as recommended in the literature [ 17 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

Assessment of the capacity to consent to treatment in patients admitted to acute medical wards

et al. 2009

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“…20 The geriatrician has extensive clinical and research experience in assessing capacity. 6,18 Panel members reviewed both videotaped assessments, discussed the case with each expert, then reached a consensus decision regarding the participant's capacity. The panel could also decide that the participant's status fluctuated between the expert assessments, in which case the participant was excluded from the final analysis.…”

Section: Measurementsmentioning

confidence: 99%

“…5 Some existing measures of specific capacity have not been evaluated on patients, 6 while others have been evaluated by trained researchers and experts on patients making decisions about specific psychiatric treatments. [7][8][9] There are no studies of specific capacity assessment that use the treating clinician as the assessor, and no studies that focus on medical patients who are facing actual decisions about medical treatment.…”

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confidence: 99%

Assessment of patient capacity to consent to treatment

et al. 1999

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OBJECTIVE:To compare results of a specific capacity assessment administered by the treating clinician, and a Standardized Mini-Mental Status Examination (SMMSE), with the results of expert assessments of patient capacity to consent to treatment. DESIGN:Cross-sectional study with independent comparison to expert capacity assessments. SETTING:Inpatient medical wards at an academic secondary and tertiary referral hospital. PARTICIPANTS:One hundred consecutive inpatients facing a decision about a major medical treatment or an invasive medical procedure. Participants either were refusing treatment, or were accepting treatment but were not clearly capable according to the treating clinician. MEASUREMENTS AND MAIN RESULTS:The treating clinician (medical resident or student) conducted a specific capacity assessment on each participant, using a decisional aid called the Aid to Capacity Evaluation. A specific capacity assessment is a semistructured evaluation of the participant's ability to understand relevant information and appreciate reasonably foreseeable consequences with regard to the specific treatment decision. Participants also received a SMMSE administered by a research nurse. Participants then had two independent expert assessments of capacity. If the two expert assessments disagreed, then an independent adjudication panel resolved the disagreement after reviewing videotapes of both expert assessments. Using the two expert assessments and the adjudication panel as the reference standard, we calculated areas under the receiver-operating characteristic curves and likelihood ratios. The areas under the receiveroperating characteristic curves were 0.90 for specific capacity assessment by treating clinician and 0.93 for SMMSE score (2 p ‫؍‬ .48). For the treating clinician's specific capacity assessment, likelihood ratios for detecting incapacity were as follows: definitely incapable, 20 (95% confidence interval [CI] 3.6, 120); probably incapable, 6.1 (95% CI 2.

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A randomized trial of a decisional aid for mental capacity assessments

Cited by 13 publications

References 16 publications

Cognitive impairment and PD patients' capacity to consent to research

Cognitive impairment and PD patients' capacity to consent to research

Assessment of the capacity to consent to treatment in patients admitted to acute medical wards

Assessment of patient capacity to consent to treatment

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