Should First-generation Comprehensive Geriatric Assessment instruments be replaced by Third-generation? Comparison of the Minimal Geriatric Screening Tool (MGST) and the interRAI Acute Care (interRAI-AC) in acute clinical practice
Poster presentation at XIXth IAGG World Congress of Gerontology and Geriatrics location:Paris date:5-9 July
Comprehensive Geriatric Assessment (CGA) has evolved. First, CGA consisted of a collection of single-domain, individually validated, measures. The ‘Second-generation’ introduced health setting-specific assessment with omni-comprehensive nature. Improving data transfer in transitional care, ‘third-generation’ CGA consists of instruments with a common set of standardized items across settings.
The aim of the study is to compare the us(ibility) of the ‘first-generation’ MGST and the recently released ‘third-generation’ interRAI-AC in clinical practice.
Methods and materials
A comparison based on theory is validated by an expert panel consisting of 8 geriatricians.
Both methods aim at multi-domain geriatric assessment, each with different scope and goal.
InterRAI-AC, tailored for acute settings, intends to screen all geriatric domains. Based on systematic observational data, risk domains are triggered. Four observation periods outline the evolution of patients’ functioning over stay. The simplicity of the method is appropriate for application on general medical and surgical wards, filling geriatric knowledge gaps. In a next step, in-depth assessment with problem-specific instruments is essential. The method facilitates data transition across care settings.
MGST contains international validated instruments (e.g. Katz, Lawton, Cornell). Assessment is usually triggered by care givers’ clinical impression based on geriatric expertise. In real terms, usually a selection of domains is assessed only once. The components of ‘first-generation’ assessment imply profound examination and require specialized disciplines.
Both standardized approaches are mutually exclusive. A cascade-system is proposed to integrate the complementary methods in practice. First, the systematic interRAI-AC assessment detects risk domains and suggests subsequent care tracks in the form of clinical protocols. In a next stage, components of MGST conduct in-depth examination of care needs. The proposed method can be generalized to a variety of ward-types and the MGST can be substituted by a variety of ‘first-generation’ assessment tools.