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Validity of the interRAI Acute Care based on test content: a multi-center study

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Abstract

Background and aims: The MDS inter-RAI Acute Care is a comprehensive geriatric assessment tool for hospitalized older persons. The aim was to examine its validity based on test content by use in daily clinical practice. Methods: Clinical staff of multiple disciplines assessed 256 older persons (83.2±5.2 years; 60% female) in a cross-sectional multicenter study in nine acute hospitals. Test content was empirically tested by frequency distribution of clinical deficits, missing, and invalid data. Item relevance was quantified by the content validity index (CVI) and modified kappa statistics (κ*) based on assessors’ judgment. Results: Clinical deficits exceeded 30% in the majority of items (67%) across all assessment periods. Mean missing data for premorbid, admission, day-14 and discharge assessments were 9.7%, 5.3%, 29.3% and 13.7%, respectively. Invalid scores ranged from 3.9% to 26.7%. Of the 98 items, 82 had excellent CVI (≥0.78). Item relevance was excellent for 82 (κ*≥0.75), good for 9 (0.60≤κ*=0.74) and fair for 3 items (0.40=≤κ*<0.60). Item revision may optimize clinical relevance: removing 4 items with poor relevance would increase the overall CVI from 0.89 to 0.91, meeting the standard of excellent content validity (CVIaverage≥0.90). Conclusions: Although the frequency distribution provides evidence that item selection of the interRAI Acute Care is appropriate for the targeted population, its use in a clinical context reveals a substantial number of missing and invalid data. To improve validity, training should pay specific attention to items with low compliance and invalid records. Software applications should also be designed to improve data quality.

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Authors and Affiliations

  1. Center for Health Services and Nursing Research, KU Leuven, Kapucijnenvoer 35, PB 7001, 3000, Leuven, Belgium

    Nathalie I. H. Wellens, Mieke Deschodt, Philip Moons & Koen Milisen RN, PhD

  2. Leuven University Division of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium

    Mieke Deschodt, Steven Boonen, Johan Flamaing & Koen Milisen RN, PhD

  3. Leuven University Center for Metabolic Bone Diseases, Leuven, Belgium

    Steven Boonen

  4. Center for Research in Geriatric Medicine, School of Medicine, The University of Queensland, Queensland, Australia

    Len Gray

Authors
  1. Nathalie I. H. Wellens
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  2. Mieke Deschodt
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  3. Steven Boonen
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  4. Johan Flamaing
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  5. Len Gray
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  6. Philip Moons
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  7. Koen Milisen RN, PhD
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Correspondence to Koen Milisen RN, PhD.

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Wellens, N.I.H., Deschodt, M., Boonen, S. et al. Validity of the interRAI Acute Care based on test content: a multi-center study. Aging Clin Exp Res 23, 476–486 (2011). https://doi.org/10.1007/BF03325244

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  • DOI: https://doi.org/10.1007/BF03325244

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