It‘s MAGIC – Validation of a Simple Geriatric Assessment in Family Medicine
DOI: 10.3238/zfa.2016.0169-0175german translation / full article
Background: It is challenging for family practitioners to identify older vulnerable patients in routine care. A geriatric assessment can contribute to this task. Based on the European STEP-assessment a notably shorter version called “MAGIC” (manageable geriatric assessment) was developed. The aim of this paper is to report on the validity and reliability of MAGIC as determined in a field test.
Methods: In a two-stage cross-sectional survey family practice patients (70+ years) received the MAGIC-assessment and one week later the longer version STEP. Additionally, every fourth patient participated in a cognitive interview and provided feedback on the intention and meaning of the MAGIC-questions. To analyse the test-retest-reliability, the MAGIC findings at t0 and t1 were compared and a Spearman correlation performed. Cognitive interviews were assessed using an inductive approach with simple coding frames according to Mayring.
Results: 30 family physicians from the southern region of Hannover took part. From these practices a total of 60 patients with an average age of 79.7 years were recruited (participation rate 47 %). MAGIC detected a median of four out of a maximum of nine health problems. In general, patients easily understood the meaning and intention of the MAGIC-questions. In their explanations, they referred to the medical context and also described the consequences for their daily life. Test-retest agreement of MAGIC ranged between 83.3 % for the item “depression“ and 100 % for “social participation“.
Conclusions: MAGIC, to identify vulnerable older patients, has produced stable results and a good understanding of its content. The MAGIC-questions encourage patients to assess their health and personal problems in the context of their everyday life, which is conducive to identifying vulnerable patients’ needs. Our results add to the existing knowledge of validity and reliability, and provide an evidence base that is legally required for performing a geriatric assessment in German family practices.