[Validation of indicators of the management of cognitive impairment in geriatric assessment units].
Bibliographic record
Abstract
OBJECTIVE: To analyze and adapt a set of quality indicators for assessment and management of patients with cognitive disorders, which are seen very frequently in geriatric assessment units in Quebec. DESIGN: Modified Delphi technique. SETTING: Province of Quebec. PARTICIPANTS: Seven clinicians from 3 different medical faculties in Quebec were selected for their expertise in dementia and geriatric care. METHOD: From among the indicators developed in 2001 using the RAND method, 22 items selected for their relevance to evaluation and management of cognitive disorders were adapted to clinical practice in the Quebec hospital system. These indicators, along with evidence from the literature, were submitted by mail to a panel of experts. The experts were asked to rate, on a scale of 1 to 9, their level of agreement with the indicators in terms of their validity and quality and the need for them to be recorded in patients' medical charts. For an indicator to be retained, it had to be accepted according to its median value, to be rated in the upper third of the scale, and to be approved by the panelists. Indicators not accepted at first were modified according to experts' comments and then re-submitted to the same panel for a second round. RESULTS: Of 22 indicators submitted in the first round, 21 were validated. They covered assessment, investigation, evaluation, treatment, and follow-up. The indicator found questionable was modified and then accepted during the second round. CONCLUSION: This study identified 22 indicators relevant to assessment and management of patients with cognitive disorders in geriatric assessment units. These indicators will serve as a basis for evaluation of dementia in a larger study of the quality of care in all short-term geriatric assessment units in Quebec.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.042 | 0.090 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".