Abstract

Objectives

While the Minimum Data Set (MDS) 3.0 has adopted Patient Health Questionnaire (PHQ)-9 to screen for depression and rephrased language for behavioral symptoms among nursing home residents, it remains unclear how well the assessment data agree with medical records.

Design

Using a retrospective review of MDS 3.0 linked to medical records between October 2010 and November 2017, we included residents with at least one quarterly or short-term (day 30 or day 60) MDS 3.0 assessment of depression PHQ-9 (n = 446) or behavioral symptoms (n = 460). For each resident of each cohort, we randomly selected an eligible MDS 3.0 depression and behavioral symptom assessment and compared against the respective medical diagnoses recorded within 30 days before the MDS 3.0 assessment.

Results

Percent agreement was high for depression (90.1%) and behavioral symptoms (89.3%). Negative agreement was high for depression (94.8%) and behavioral symptoms (94.3%), while positive agreement was low for both conditions (4.3% and 10.9%).

Conclusion

MDS 3.0 depression and behavioral symptoms had high overall and negative agreement, but low positive agreement with clinician diagnoses. MDS 3.0 data may be useful in ruling out depression and behavioral symptoms. Confirmation of the findings in a representative sample of nursing homes is warranted.

中文翻译：

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最小数据集 3.0 抑郁症和行为症状与疗养院临床诊断的一致性

摘要

目标

虽然最小数据集 (MDS) 3.0 已采用患者健康问卷 (PHQ)-9 来筛查疗养院居民的抑郁症并改写行为症状的语言，但仍不清楚评估数据与医疗记录的一致性程度。

设计

通过对 2010 年 10 月至 2017 年 11 月期间与医疗记录相关的 MDS 3.0 进行回顾性审查，我们纳入了至少一个季度或短期（第 30 天或第 60 天）MDS 3.0 抑郁症评估 PHQ-9 的居民（n  = 446）或行为症状 ( n  = 460)。对于每个队列的每位居民，我们随机选择符合条件的 MDS 3.0 抑郁和行为症状评估，并与 MDS 3.0 评估前 30 天内记录的相应医学诊断进行比较。

结果

抑郁症（90.1%）和行为症状（89.3%）的一致性百分比很高。抑郁症 (94.8%) 和行为症状 (94.3%) 的负面一致性较高，而两种情况的正面一致性较低 (4.3% 和 10.9%)。

结论

MDS 3.0 抑郁和行为症状的总体一致性和阴性一致性较高，但与临床医生诊断的阳性一致性较低。MDS 3.0 数据可能有助于排除抑郁和行为症状。有必要在具有代表性的疗养院样本中确认调查结果。