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Table 1 Overview of STEP Items, results of the pre-selections, instruments, and qualitative arguments given in pre-selections A and D

From: “It’s MAGIC” - development of a manageable geriatric assessment for general practice use

STEP item (plus instrument if included in MAGIC) Selected in pre-selection part Qualitative arguments given
A B C D in pre-selection part A in pre-selection part D
Decreased performance with everyday tasksCOOP/WONCA Charts [12] x   x   A question concerning function was included because ADL is a crucial content of a geriatric assessment  
Decreased maximal exercise capacity for two minutes       
Problems with BADL   x   x   Important for independence
Problems with IADL   x x x  
Problems with housing       
No help in emergencyLachs [13]    x x   A social network is considered important, especially as a missing network leads to insecurity and anxiety
No help in sickness      
No person to trustOARS [14]   x   x  
Being a caregiver x   x   Being a caregiver is highly important for the patient with regard to preserving autonomy  
Financial problems       
Breathlessness x     Health problem was rated as important for GP and patient  
Chest pain x     Chest pain is often new to GP, important for the patient; interventions are often planned  
Claudication x     Claudication is often new to GP; health problem is important for doctor and patient; in many cases interventions were planned and conducted  
Dizziness x     Interventions are often planned and conducted subsequently to the assessment  
Difficulty sleeping x     Sleeplessness has high prevalence and is often new to the GP  
Pain x   x   Pain was included because of its high prevalence  
Weight loss x     Interventions are often planned and conducted subsequently to the assessment  
History of fallsTinetti [15] x x x x Falls are often new to GP All GPs agreed that this item is essential in a geriatric assessment
History of cardiac infarction       
History of stroke       
History of fractures       
Problems with chewing    x    
Urinary incontinenceSandvick et al. [16] x x x   Urinary incontinence has a high prevalence and is often new to the doctor, patients often keep quiet about the problem because of shame  
Fecal incontinence/constipation x x    Problem is important for the patient  
Problems with visionLambeth Disability Questionnaire [17,18] x x x x There was consensus among the researchers that this health problem must be included as “basic GA item” Despite some controversies (no consequence, most patients regularly visit an ophthalmologist), most GPs recommend the inclusion of this item because patients do not address the problem on their own
Problems with hearingLambeth Disability Questionnaire [17,18] x x x x There was consensus among the researchers that this health problem must be included as “basic GA item” Despite some controversies (can easily be detected without an assessment), most GPs recommend the inclusion of this item because patients do not address the problem on their own. Furthermore, good hearing is important for social activities.
DepressionWhooley et al. [19] x x x x Health problem is important for GP and patient; many planned and conducted interventions All GPs agreed that this item is essential in a geriatric assessment
There was consensus among the researchers that this health problem must be included as “basic GA item”
Mourning       
Loneliness       
Anxiety x     Anxiety is important for the patient; monitoring is important for differentiation between depression and anxiety  
Smoking       
Alcohol abuse       
No healthy diet   x   x   Especially the ability to prepare a meal seems to be important for a balanced diet, the item is closely linked to the IADL aspects
Too little exercise       
Immunization missing or unknownSTEP [1] x     Very high prevalence, problem is often new to GP  
Problems with medication   x x x   The item seems to be very important for GPs because lack of compliance, use of OTC drugs, and prescriptions of other medical specialists unknown to the GP are frequent problems
Hypertension       
Arrhythmia       
High blood sugar or known diabetes       
High cholesterol       
Thyroid dysfunction       
Abnormal clock drawing testClock drawing test [20,21] x x x x Problem is often new to GP; A basic cognition test is central to a geriatric assessment All GPs agreed that this item is essential in a geriatric assessment
Abnormal timed-up-and-go    x    All GPs agreed that this item is essential in a geriatric assessment
Foot problems x   x   High prevalence  
  1. Items selected for MAGIC are in bold text type.