Reliability of screening tests for health-related problems among low-income elderly

Screening tests for health problems can identify elderly people who should undergo the Comprehensive Geriatric Assessment, enabling the planning of actions to prevent disability. The aim of this study was to analyze the inter-rater reliability (IRR) of self-assessment questions (SAQ) and performance tests (PT) recommended in Brazil, in a sample of low-income elderly people, through an exploratory study performed with 165 elderly assessed by two professionals on different days. IRR was evaluated using the intraclass correlation coefficient (ICC) for continuous variables and the kappa statistic for categorical ones. The IRR for the PT (muscle strength, mobility body mass index, vision) was excellent and presented ICC values greater than 0.75. By contrast, the IRR for SAQ (urinary incontinence, self-perceived health and hearing impairment) was intermediate. Only the fall-related item presented a good IRR. In this study single SAQ had poor reliability when compared to PT, suggesting the necessity of revision of subjective self-assessment items with low reproducibility before implementation.

健康问题筛查可识别需接受老年综合评估（Comprehensive Geriatric Assessment）的老年人群，为制定预防失能的干预方案提供依据。本研究旨在分析巴西推荐的自我评估问卷（self-assessment questions, SAQ）与功能测试（performance tests, PT）在低收入老年人群中的评定者间信度（inter-rater reliability, IRR）；研究为探索性设计，共纳入165名老年人，由两名专业人员于不同日期分别完成评估。针对连续变量采用组内相关系数（intraclass correlation coefficient, ICC）、分类变量采用kappa统计量对评定者间信度进行评估。功能测试涵盖肌肉力量、活动能力、体质量指数与视力，其评定者间信度极佳，组内相关系数值均大于0.75。相较而言，自我评估问卷涉及尿失禁、自我健康感知与听力损伤相关条目，其评定者间信度处于中等水平，仅与跌倒相关的条目信度良好。本研究显示，单项自我评估问卷的信度相较于功能测试较差，提示在正式推广应用前，需对重现性较低的主观自我评估条目进行修订完善。