Effects of re‐training sessions in RUDAS assessment in a cohort of evaluators

Abstract

AbstractBackgroundThe RUDAS scale has been widely used in cohorts and trials, nevertheless this tool is complex and there are no guidelines for using it. Since the RUDAS may be prone to mistakes, even when medical staff is trained once, we aimed to determine the number of correct assessments per each evaluator of a large cohort of adults regarding dementia risk factors after sessions of re‐training.MethodThis was a longitudinal study of 22 evaluators of a large study on dementia risk factors in Antofagaste (Chile) and Quito (Ecuador). Use of RUDAS was established in the study protocol, so all evaluators were trained once to use this tool before study initiation. In order to ensure accuracy between evaluators, they were scheduled for five video‐sessions of re‐training leaded by an expert Neurologist. This sessions lasted 2.5 hours and the aim was to identify mistakes and doubts when performing RUDAS. After each session evaluators had a written test. The content was a simulation of a typical dementia case to be assessed by RUDAS. We collected the number of correct answers by domain.ResultWe assessed the mean number of correct answers by domain and the changes from baseline to the fifth test (visuospatial orientation: 4.25 → 4.89, praxis: 0.25 → 1.05, visuo‐constructional drawing: 0.05 → 2.68, judgement: max. 1.8 → 3, memory recall: 0.2 → 0, language: 5.7 → 8). Re‐training had a significant increase of correct answers in all domains. Despite the majority showed an increase in score from baseline to the fifth test, the mean score in fifth test was higher than in the prior tests only in judgement, memory recall and visuo‐constructional drawing domains. In the other domains we found that the fourth test scored higher than the fifth one, nevertheless the difference was not clinically important.ConclusionTraining and re‐training are important steps in the approach and use of an assessment tool in trials and cohorts. RUDAS is a complex tool that may be prone to mistakes, therefore we recommend at least five sessions of re‐training to identify mistakes and doubts among evaluators.