Home › Research › Caregiving
The Clinician Interview-Based Impression (CIBI): a clinician's global change rating scale in Alzheimer's disease
Knopman DS, Knapp MJ, Gracon SI, Davis CS.. Neurology, 1994-12-01
Topic: Risk, prevention and care in population studies
Global assessments are Food and Drug Administration-required primary outcome measures in trials of putative antidementia drugs. Global ratings are intended to provide an index of clinical importance of change that cannot be obtained from quantitative assessment measures such as mental status examinations. We examined the performance of a global assessment of change instrument, the Clinician Interview-Based Impression (CIBI), in the placebo group of a 30-week, randomized, double-blind clinical trial of tacrine in patients with Alzheimer's disease. Initially there were 184 placebo patients, of whom 125 completed the 30-week study. Descriptive statistics, correlations with changes on other assessment instruments, and test-retest reliability were determined for the CIBI. At week 30, clinicians rated more than 40% of patients on the CIBI as unchanged. The CIBI ratings were weakly but significantly correlated, in the expected direction, with change scores on the quantitative cognitive assessments. The CIBI was modestly reliable on test-retest at weeks 22 and 24 but less reliable compared with other quantitative outcome measures. Modifications of the CIBI that might improve its reliability and acceptance include (1) no restrictions on the form of the bedside mental status assessment, (2) inclusion of caregiver input, and (3) better definition of ratings on the global scale. Global instruments, if properly constructed, can provide an index of clinically important change for the assessment of dementia patients.
Key findings
- The CIBI ratings were weakly but significantly correlated, in the expected direction, with change scores on the quantitative cognitive assessments.
- The CIBI was modestly reliable on test-retest at weeks 22 and 24 but less reliable compared with other quantitative outcome measures.
Why it matters
This study examined the Clinician Interview-Based Impression (CIBI) in the placebo group of a tacrine trial and found it was modestly reliable and weakly correlated with cognitive assessments. It suggests that modifications to the CIBI might improve its reliability and acceptance as a global change rating scale.
New to this subject? Start with our plain-English guide: Caregiving →
Study details
- Evidence strengthHigh
How this study scored 65/100
Published in a leading specialty journal, and it is a randomised controlled trial. Scored zero for sample size and effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1994 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 2 / 2 | Randomised and blinded or placebo-controlled (as stated in the record) |
| Times cited | 5 / 7 | Cited 213 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.3 citations a year over 34 year(s) since 1994 |
| Impact for its field and year | 2 / 6 | Cited 2.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 11 other studies in this library |
| Still being cited | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Charles S. Davis: h-index 37 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Minnesota: institution h-index 1,568 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 7991118) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 65 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Knopman, D. S., Knapp, M. J., Gracon, S. I., & Davis, C. S. (1994). The Clinician Interview-Based Impression (CIBI): a clinician's global change rating scale in Alzheimer's disease. Neurology. https://doi.org/10.1212/wnl.44.12.2315
Vancouver
Knopman DS, Knapp MJ, Gracon SI, Davis CS. The Clinician Interview-Based Impression (CIBI): a clinician's global change rating scale in Alzheimer's disease. Neurology. 1994. doi:10.1212/wnl.44.12.2315. PMID: 7991118.
BibTeX
@article{knopman1994-7991118,
author = {Knopman, D. S. and Knapp, M. J. and Gracon, S. I. and Davis, C. S.},
title = {{The Clinician Interview-Based Impression (CIBI): a clinician's global change rating scale in Alzheimer's disease}},
journal = {Neurology},
year = {1994},
doi = {10.1212/wnl.44.12.2315},
pmid = {7991118},
url = {https://doi.org/10.1212/wnl.44.12.2315}
}
Later studies that cite this one
11 studies in the alzhub library list this one in their references. Showing the 8 highest-scoring.