Evaluating the accuracy and reliability of telephone‐derived Clinical Dementia Rating scores: A comparative analysis with in‐person assessments
Araya Dimtsu Assfaw, Chengjie Xiong, Krista L. Moulder, John C. MorrisAbstract
INTRODUCTION
The Clinical Dementia Rating (CDR) scale typically is administered in person, but use of telephone‐based, informant‐only assessments increased during the coronavirus disease 2019 (COVID‐19) pandemic. The correspondence of informant‐only assessments with in‐person ratings remains unclear.
METHODS
We analyzed 1,140 paired in‐person and telephone assessments from the Knight Alzheimer's Disease Research Center Memory and Aging Project conducted within 12 months. Agreement for global CDR and CDR Sum of Boxes (CDR‐SB) was examined using kappa statistics, intraclass correlation coefficients (ICCs), and Bland–Altman methods; classification performance of telephone global CDR score ≥ 0.5 was assessed.
RESULTS
Agreement for the global CDR was moderate ( κ = 0.53, 95% CI: 0.47–0.59). CDR‐SB demonstrated moderate reliability (ICC = 0.69, 95% confidence interval [CI]: 0.65–0.73). Telephone CDR‐SB scores averaged 0.40 points higher than in‐person scores, with wide limits of agreement. Sensitivity was 64.2% and specificity 91.9%.
DISCUSSION
Telephone CDR‐SB shows moderate concordance with in‐person CDR‐SB but shows consistent score inflation, which may limit clinical staging utility.