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The Hopkins Competency Assessment Test: A Brief Method for Evaluating Patients' Capacity to Give Informed Consent
Jeffrey S. Janofsky; Richard J. McCarthy; Marshal F. Foistein
Psychiatric Services 1992; doi:
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This study was supported by grants from the National Institute of Mental Health to Drs. Janofsky and Folstein, from the National Institutes of Health to Dr. Folstein, and from the National Institute of Neurological Diseases and Stroke, the National Institute of Aging, and Meridian Healthcare Systems.

Johns Hopkins University School of Medicine in Baltimore; Meyer 144, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, Maryland 21205

George Washington University in Washington, D.C.

Johns Hopkins University School of Medicine in Baltimore

1992 by the American Psychiatric Association

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Abstract

The Hopkins Competency Assessment Test (HCAT), a brief instrument for evaluating the competency of patients to give informed consent or write advance directives, consists of a short essay and a questionnaire for determining patients' understanding of the essay. In a study to validate the instrument, 41 medical and psychiatric inpatients answered the questionnaire after reading the essay while hearing it read aloud. A forensic psychiatrist who was blind to the HCAT scores later examined the patients for competency. A subject's number of correct answers to the HCAT questionnaire was an accurate indicator of clinical competency as assessed by the psychiatrist. The results suggest that the HCAT is a useful tool for rapidly screening patients for competency to make treatment decisions.

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