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    J Geriatr Psychiatry Neurol. 1996 Oct;9(4):176-80.

    Clinical evaluation of global change in Alzheimer's disease: identifying consensus.

    Olin JT, Schneider LS, Doody RS, Clark CM, Ferris SH, Morris JC, Reisberg B, Schmitt FA.

    University of Southern California School of Medicine, Los Angeles, USA.

    It is important that clinicians who rate global change as part of Alzheimer's disease (AD) clinical drug trials agree on a relevant set of behaviors and information to be considered in formulating their rating. Yet, consensus among raters has been difficult to establish, and inter-rater reliability of clinical global impression of change (CGIC) ratings has been low. In preparation for the development of a new CGIC scale to be used in AD clinical trials, the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC), we surveyed clinicians at sites comprising the National Institute on Aging-sponsored ADCS participating centers to identify whether or not consensus regarding CGICs exists. Overall, respondents reported that a CGIC should include an assessment of the patient's function and mental status, a care giver interview, and a standardized set of questions, and it should take approximately 20 minutes per interview. Depending on a patient's level of impairment, raters consider different areas of behavior in formulating a CGIC rating. These findings demonstrate the considerable consensus regarding the CGIC rating process, and were integrated into the design of the ADCS-CGIC, currently in use.

    PMID: 8970010 [PubMed - indexed for MEDLINE]

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