“Establishing the criterion validity of the interRAI Check-Up Self-Report instrument”

Abstract

Background: Low and middle-income countries have growing older populations and could benefit from the use of multi-domain geriatric assessments in overcoming the challenge of providing quality health services to older persons. This paper reports on the outcomes of a study carried out in Cape Town, South Africa on the validity of the interRAI CheckUp Self-Report instrument, a multi-domain assessment instrument designed to screen older persons in primary health settings. This is the first criterion validity study of the instrument. The instrument is designed to identify specific health problems and needs, including psychosocial or cognition problems and issues related to functional decline. The interRAI CheckUp Self-Report is designed to be compatible with the clinician administered instruments in the interRAI suite of assessments, but the validity of the instrument against clinician ratings has not yet been established. We therefore sought to establish whether community health workers, rather than trained healthcare professionals could reliably administer the self-report instrument to older persons. Methods: We evaluated the criterion validity of the self-report instrument through comparison to assessments completed by a clinician assessor. A total of 112 participants, aged 60 or older were recruited from 7 seniors clubs in Khayelitsha, Cape Town. Each participant was assessed by one of two previously untrained, non-healthcare personnel using the CheckUp Self-report version and again by a trained assessor using the clinician version of the interRAI CheckUp within 48 h. Our analyses focused on the degree of agreement between the self-reported and clinician-rated versions of the CheckUp based on the simple or weighted kappa values for the two types of ratings. Binary variables used simple kappas, and ordinal variables with three or more levels were examined using weighted kappas with Fleiss-Cohen weights. Results: Based on Cohen's Kappa values, we were able to establish that high levels of agreement existed between clinical assessors and lay interviewers, indicating that the instrument can be validly administered by community health workers without formal healthcare training. 13% of items had kappa values ranging between 0.10 and 0.39; 51% of items had kappa values between 0.4 and 0.69; and 36% of items had values of between 0.70 and 1.00. Conclusion: Our findings indicate that there is potential for the CheckUp Self-Report instrument to be implemented in under-resourced health systems such as South Africa's.

Validation of a classification to identify emergency department visits suitable for subacute and virtual care models: a randomised single-blinded agreement study protocol

“…Leveraging physician determination as a criterion is an appropriate measure to test experimental validity in this circumstance, as there is no gold-standard classification to establish appropriateness or has not been experimentally validated. 28 Given validation testing tends to perform better on data used to construct a classification or scale, examining EDAC with a panel of physicians who are unaware of the EDAC’s components can provide a more unbiased estimate of EDAC’s true accuracy and performance. 22 29 30 This also mimics clinical practice, where emergency physicians are not given this information during clinical decision-making.…”

Before the COVID-Vaccine—Vulnerable Elderly in Homecare

“…Shortly after the outbreak of COVID-19, the interRAI organization ( , accessed on 15 December 2021) developed a web-based screening tool to identify vulnerable elderly and adults with disabilities living in the community who were at risk during the pandemic and to determine individuals who required further assessment and/or intervention. InterRAI is a non-profit network of international researchers, clinicians, and policy experts that develops and validates comprehensive assessments to identify the strengths, preferences, and needs of vulnerable persons with complex health conditions [ 18 , 19 , 20 ]. The interviews started around the beginning of June.…”

“…The survey contains 27 items, some with sub-items, in a closed-ended multiple-choice format. The CVS was developed by including self-reporting questions that were previously validated through their inclusion in two pre-existing interRAI instruments: (a) the interRAI Contact Assessment (CA) [ 21 ] and (b) the interRAI Check-Up (Self-Reported version) (CU) [ 19 , 22 ]. Both pre-existing tools have been tested and used with vulnerable community-dwelling older adult populations in jurisdictions in Canada and South Africa and found to have a sufficient level of validity and reliability.…”

Mood Disturbances Across the Continuum of Care Based on Self-Report and Clinician Rated Measures in the interRAI Suite of Assessment Instruments

“…Most of these data are from the province of Ontario; however, that province still uses an older version of the nursing home instrument 2 ( 75 , 76 ) that excludes self-report items so data from the province of New Brunswick based on the newer interRAI LTCF assessment were used instead. Second, pilot or regional implementations of interRAI systems were done for community mental health services [using interRAI Community Mental Health ( 44 )], wellness checks in home care [using the interRAI Check-Up Self-report version ( 77 , 78 )], and emergency department screening [using the interRAI Emergency Department Contact Assessment ( 79 )] of older adults in acute hospitals. The third type of implementation was research-only use of interRAI self-report items in telephone and on-line surveys of the general population.…”

“…The responses are strictly based on the person's self-report without clinical judgement being applied by the interviewer. Previous research has reported in the reliability and validity of the CU-SR in community-based research ( 77 , 78 ).…”