COMPASS
Research type
Research Study
Full title
Validation & Reliability of Oxford COMPetency ASSessment (COMPASS) for guiding mental capacity assessments.
IRAS ID
241571
Contact name
Nele Demeyere
Contact email
Sponsor organisation
University of Oxford
Duration of Study in the UK
5 years, 0 months, 0 days
Research summary
Research Summary
COMPASS is being developed as a computerised tablet-based, standardised assessment tool of mental capacity. It comprises of six neuropsychological tests which follow neuropsychological principles in order to specifically and objectively measure performance on the four aspects of the Mental Capacity Act (MCA) (2005). The MCA (2005) states that in order to be attributed mental capacity, a patient needs to be able to: (i) understand the information given, (ii) retain the information, (iii) weigh up the information, and (iv) communicate the decision made.
This study seeks to establish whether an objective cognitive profile from neuropsychological tasks included in the Oxford COMPetency ASSessment (COMPASS) can help determine mental capacity judgements (e.g. around power of attorney) for patients whose mental capacity has been called into question.
Lay summary of study results: Mental capacity is defined as a time- and decision-specific ability which can only affected when someone has an impairment in mind or brain (e.g., an acquired brain injury or dementia). A professional needs to prove incapacity when deciding whether someone can make decisions for themselves. Clinicians' assessment of mental capacity is not conducted well in the UK, and it is not up to standard of what is expected when assessing one's capacity. Our project aimed to standardise how capacity is assessed and bring objectivity and evidence into decision making.
We developed, and assessed the accuracy of, a new computer tablet tested designed to align with the Mental Capacity Act (2005; MCA) which governs England and Wales. The app can assess key thinking skills aligned to the MCA, such as comprehension, retention of information, and consideration/weighing-up of information. Typically, mental capacity is assessed in an interview with a healthcare professional, but the interview lacks objective evidence of the individual's cognitive abilities. Our app aims to book end either the start of an assessment or the end, either to guide how best to communicate with an individual, or to review the interview considering cognitive impairments. We do not intend to replace proper, qualified, interviewing of capacity with our app, but to compliment it.
We developed this app and then tested it in stroke survivors deemed to have capacity or not and compared performance of our app to clinical interview and other assessments. We found our app to be accurate at capturing thinking skills relevant to mental capacity.
We further ran audits of capacity decision making in hospitals and how evidence that current standards for the assessment of capacity are poor.
Finally, we examined how our test compares to real decisions around capacity for individuals in a complex medicine unit and found our app to be accurate at differentiating those with and without capacity to make decisions.
Further evidence needs to be gathered to fully cement the COMPASS (our app) as a useful tool to compliment decisions regarding mental capacity.Summary of results
Mental capacity is defined as a time- and decision-specific ability which can only affected when someone has an impairment in mind or brain (e.g., an acquired brain injury or dementia). A professional needs to prove incapacity when deciding whether someone can make decisions for themselves. Clinicians' assessment of mental capacity is not conducted well in the UK, and it is not up to standard of what is expected when assessing one's capacity. Our project aimed to standardise how capacity is assessed and bring objectivity and evidence into decision making.
We developed, and assessed the accuracy of, a new computer tablet tested designed to align with the Mental Capacity Act (2005; MCA) which governs England and Wales. The app can assess key thinking skills aligned to the MCA, such as comprehension, retention of information, and consideration/weighing-up of information. Typically, mental capacity is assessed in an interview with a healthcare professional, but the interview lacks objective evidence of the individual's cognitive abilities. Our app aims to book end either the start of an assessment or the end, either to guide how best to communicate with an individual, or to review the interview considering cognitive impairments. We do not intend to replace proper, qualified, interviewing of capacity with our app, but to compliment it.
We developed this app and then tested it in stroke survivors deemed to have capacity or not and compared performance of our app to clinical interview and other assessments. We found our app to be accurate at capturing thinking skills relevant to mental capacity.
We further ran audits of capacity decision making in hospitals and how evidence that current standards for the assessment of capacity are poor.
Finally, we examined how our test compares to real decisions around capacity for individuals in a complex medicine unit and found our app to be accurate at differentiating those with and without capacity to make decisions.
Further evidence needs to be gathered to fully cement the COMPASS (our app) as a useful tool to compliment decisions regarding mental capacity.REC name
South Central - Oxford C Research Ethics Committee
REC reference
18/SC/0044
Date of REC Opinion
9 Apr 2018
REC opinion
Further Information Favourable Opinion