Clinical evaluation of global change in Alzheimer's disease: Identifying consensus

Jason T. Olin, Lon S. Schneider, Rachelle S. Doody, Christopher M. Clark, Steven H. Ferris, John C. Morris, Barry Reisberg, Frederick A. Schmitt

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


It is important that clinicians who rate global change as part of Alzheimer's disease (AD) clinical drug trials agree on a relevant set of behaviors and information to be considered in formulating their rating. Yet, consensus among raters has been difficult to establish, and inter-rater reliability of clinical global impression of change (CGIC) ratings has been low. In preparation for the development of a new CGIC scale to be used in AD clinical trials, the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC), we surveyed clinicians at sites comprising the National Institute on Aging-sponsored ADCS participating centers to identify whether or not consensus regarding CGICs exists. Overall, respondents reported that a CGIC should include an assessment of the patient's function and mental status, a care giver interview, and a standardized set of questions, and it should take approximately 20 minutes per interview. Depending on a patient's level of impairment, raters consider different areas of behavior in formulating a CGIC rating. These findings demonstrate the considerable consensus regarding the CGIC rating process, and were integrated into the design of the ADCS-CGIC, currently in use.

Original languageEnglish
Pages (from-to)176-180
Number of pages5
JournalJournal of Geriatric Psychiatry and Neurology
Issue number4
StatePublished - Oct 1996

ASJC Scopus subject areas

  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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