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C MacKnight

Publications and source records attributed to C MacKnight.

38 records · Page 3Linked to original sources
PubMed1995

A Hierarchical Assessment of Balance and Mobility.

The Hierarchical Assessment of Balance and Mobility (HABAM) is a new instrument which displays changes in balance and mobility graphically. To assess the validity, reliability, and responsiveness to change of the HABAM it was compared with the Barthel Index, the Spitzer Quality of Life Index, the Folstein Mini Mental Status Examination, and the Lawton-Brody Instrumental Activities of Daily Living Scale. A consecutive sample (n = 28) of patients aged 65 and older admitted to a tertiary-care teaching hospital was studied. Convergent construct validity was assessed by correlation with the Barthel Index (r = 0.76) and its mobility subscale (r = 0.74), and discriminant validity by correlation with the Folstein Mini Mental Status Exam (r = 0.15), Lawton-Brody Instrumental Activities of Daily Living (r = 0.30), and Spitzer Quality of Life Index (r = 0.39). Reliability was demonstrated by an intra-class correlation coefficient of R1 = 0.94. Responsiveness was demonstrated by a relative efficiency of 3.13 and an effect size of 0.59. The HABAM, a new instrument to assess balance and mobility in the hospitalized elderly, is valid, reliable, and responsive to change.

Activities of Daily Living↗
PubMedDate not supplied

Inter-rater reliability of the diagnosis of vascular cognitive impairment at a memory clinic.

Consensus criteria for the diagnosis of vascular dementia (VaD) are gradually being replaced with data-based criteria. We report the inter-rater reliability of a new set of empirically-derived criteria for vascular cognitive impairment (VCI). Stratified sampling, with optimal allocation, was employed to randomly select 36 patients from the Queen Elizabeth II Health Science Centre's Memory Disability Clinic. Chart reviews were conducted independently by 4 physicians. Each physician classified the patients as having either: no cognitive impairment, VCI or Alzheimer's disease (AD). VCI was further classified both clinically (VCI without dementia, VaD or AD with a vascular component) and radiographically (infarcts, white matter changes, single strategic stroke). The intraclass correlation coefficient (ICC) for the diagnosis by physicians of VCI or otherwise was based on a repeated-measures analysis of variance with raters as the independent variable. A significant coefficient of reliability (average ICC = 0.88, 95% CI = 0.80-0.93) was obtained (H(o): rho </= 0.80, p = 0.03). Where differences in diagnosis occurred, the discrepancies most commonly resulted within the subtypes of VCI (9 cases) or between the diagnoses of AD and VCI (9 cases). Instances of diagnostic incongruity were typically due to the disagreement of a single rater (10 cases). This study demonstrates a high degree of reliability of criteria for VCI by physicians in a memory clinic, and can also be understood as an aspect of construct validation of those criteria. In the absence of a readily available biological marker for VCI, clinical criteria are necessary and can be reliably employed.

Activities of Daily Living↗