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Alzheimer's Disease Research Center, Departments of Neurology and Psychiatry (Drs. Lopez, Becker, Rezek, Rosen, Klunk, and DeKosky), University of Pittsburgh School of Medicine, Pittsburgh, PA; and the Department of Neurology (Dr. Larumbe), Clínica Universitaria de Navarra, Pamplona, Spain.
We evaluated the reliability of clinical diagnoses using the recently standardized criteria for the diagnosis of vascular dementia (VaD) developed by the National Institute of Neurological Disorders and Stroke (NINDS) and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN). Two neurologists and two psychiatrists independently reviewed clinical data abstracted from those of 42 demented subjects participating in a longitudinal study of dementia at the University of Pittsburgh. For each patient we abstracted the clinical data on a standardized form. Each physician diagnosed each case according to the NINDS-AIREN criteria, using both clinical information and MRIs. We calculated the interrater agreement for all two-way combinations of clinicians with kappa statistics, which ranged from 0.46 (moderate agreement) to 0.72 (substantial agreement). The moderate reliability observed in this study may be attributable to patient-, clinician-, or criteria-centered sources of variance.
Address correspondence and reprint requests to Dr. Oscar L. Lopez, Neuropsychology Research Program, 3600 Forbes Avenue, Suite 502, Pittsburgh, PA 15213.
Presented in part at the 45th annual meeting of the American Academy of Neurology, New York, NY, April 1993.
Supported by grant AG-03075 from the National Institute on Aging and grant MH-30915 from the National Institute of Mental Health.
Received July 19, 1993. Accepted in final form December 28, 1993
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