Computer-assisted assessment of depression and function in older primary care patients

We wanted to test the psychometric reliability and validity of self-reported information on psychological and functional status gathered by computer in a sample of primary care outpatients. Persons aged 65 years and older visiting a primary care medical practice in Baltimore (n = 240) were approached. Complete baseline data were obtained for 54 patients and 34 patients completed I-week retest follow-up. Standard instruments were administered by computer and also given as paper and pencil tests. Test-retest reliability estimates were calculated and comparisons across mode of administration were made. Separately, an interviewer administered a questionnaire to gauge patient attitudes and feelings after using the computer. Most participants (72%) reported no previous computer use. Nevertheless, inter-method reliability of the GDS15 at baseline (0.719, n = 47), intra-method reliability of the computer in time (0.797, n 31), inter-method reliability of the CESDR20 at baseline (0.740, n = 53), and the correlation between the CESDR20 computer version at baseline and follow-up (0.849, n = 34) were all excellent. The inter-method reliability of the CESDR20 at follow-up (0.615, n = 37) was tower but still acceptable. Although 28% were anxious prior to using the computer testing system, that percent decreased to 19% while using the system. The efficiency and reliability in comparison to the paper instruments were good or better. Even though most participants, had not ever used a computer prior to participating in the study, they had generally favorable attitudes toward the use of computers, and also reported having favorable experience with the computer testing system. (C) 2003 Published by Elsevier Ireland Ltd.