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BioPsychoSocial
Assessment Tools for the Elderly - Assessment Summary Sheet
Test: MacArthur
Competence Assessment Tool – Treatment (MacCAT-TR) and
Clinical Research (MacCAT-CR).
Year: 1997 (MacCAT-TR)
Domain: Psychological
Assessment Tool Category: Mental
Health
Variations/Translations: 1998
(MacCAT-CR)
Setting: Clinical or
institutional setting
Method of Delivery:
Semi-structured interview
Description: Assesses the
ability of an individual to consent to treatment or research. It
assesses all four areas of patient competence to make treatment
decisions including choice, understanding, appreciation, and
reasoning about the potential risks, benefits and consequences of
their choices.
Scoring/Interpretation:
A manual and training video is
available for health care professionals. Each question is assigned
a rating from 0 to 2. A total rating score is calculated and
reflects ability to consent. The lower the totals score the less
ability to consent to treatment.
Time to Administer: 15-20
minutes
Test Availability: Available
in the reference noted below.
Software: N/A
Website: N/A
Quantitative/Qualitative:
Quantitative
Validity (Quantitative):
Validated for certain populations including schizophrenia, older
adults with psychosis, dementia. There is questionable validity
with anorexia nervosa patients. MacCAT-T scores were compared
with score form the Brief Psychiatric Rating Scale (BPRS) for 40
psychiatric inpatients. Correlations between ratings on these
scales for BPRS total scores include: -0.7 on understanding, -0.13
for reasoning, -0.10 for appreciation, and -0.20 for expressing
choice.
Reliability (Quantitative): This
test demonstrated high inter-rater reliability. A sample of 20
patients and 20 community subjects were rated by two research
assistants and one of the authors. Intraclass correlations were
calculated among the raters and found to be 0.99 for
understanding, 0.87 for appreciation, 0.91 for reasoning, and 0.97
for expressing a choice. The intraclass correlations ranged from
0.82 to 0.99 for the individual items contributing to these
summary ratings.
References:
Grisso, T., Appelbaum, P.S., &
Hill-Fotouhi, C. (1997). The MacCAT-T: A clinical tool to assess
patient’s capacities to make treatment decisions.
Psychiatric Services, 48, 1415-1419.
Comments: N/A
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