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Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol

BACKGROUND: People with cognitive problems, and their families, report distress and uncertainty whilst undergoing evaluation for dementia and perceive that traditional diagnostic evaluation in secondary care is insufficiently patient centred. The James Lind Alliance has prioritised research to inves...

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Autores principales: Creavin, Sam T., Cullum, Sarah J., Haworth, Judy, Wye, Lesley, Bayer, Antony, Fish, Mark, Purdy, Sarah, Ben-Shlomo, Yoav
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4950265/
https://www.ncbi.nlm.nih.gov/pubmed/27430736
http://dx.doi.org/10.1186/s12875-016-0475-2
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author Creavin, Sam T.
Cullum, Sarah J.
Haworth, Judy
Wye, Lesley
Bayer, Antony
Fish, Mark
Purdy, Sarah
Ben-Shlomo, Yoav
author_facet Creavin, Sam T.
Cullum, Sarah J.
Haworth, Judy
Wye, Lesley
Bayer, Antony
Fish, Mark
Purdy, Sarah
Ben-Shlomo, Yoav
author_sort Creavin, Sam T.
collection PubMed
description BACKGROUND: People with cognitive problems, and their families, report distress and uncertainty whilst undergoing evaluation for dementia and perceive that traditional diagnostic evaluation in secondary care is insufficiently patient centred. The James Lind Alliance has prioritised research to investigate the role of primary care in supporting a more effective diagnostic pathway, and the topic is also of interest to health commissioners. However, there are very few studies that investigate the accuracy of diagnostic tests for dementia in primary care. METHODS: We will conduct a prospective diagnostic test accuracy study to evaluate the accuracy of a range of simple tests for diagnosing all-cause-dementia in symptomatic people aged over 70 years who have consulted with their general practitioner (GP). We will invite eligible people to attend a research clinic where they will undergo a range of index tests that a GP could perform in the surgery and also be assessed by a specialist in memory disorders at the same appointment. Participating GPs will request neuroimaging and blood tests and otherwise manage patients in line with their usual clinical practice. The reference standard will be the consensus judgement of three experts (neurologist, psychiatrist and geriatrician) based on information from the specialist assessment, GP records and investigations, but not including items in the index test battery. The target condition will be all-cause dementia but we will also investigate diagnostic accuracy for sub-types where possible. We will use qualitative interviews with patients and focus groups with clinicians to help us understand the acceptability and feasibility of diagnosing dementia in primary care using the tests that we are investigating. DISCUSSION: Our results will help clinicians decide on which tests to perform in someone where there is concern about possible dementia and inform commissioning of diagnostic pathways.
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spelling pubmed-49502652016-07-20 Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol Creavin, Sam T. Cullum, Sarah J. Haworth, Judy Wye, Lesley Bayer, Antony Fish, Mark Purdy, Sarah Ben-Shlomo, Yoav BMC Fam Pract Study Protocol BACKGROUND: People with cognitive problems, and their families, report distress and uncertainty whilst undergoing evaluation for dementia and perceive that traditional diagnostic evaluation in secondary care is insufficiently patient centred. The James Lind Alliance has prioritised research to investigate the role of primary care in supporting a more effective diagnostic pathway, and the topic is also of interest to health commissioners. However, there are very few studies that investigate the accuracy of diagnostic tests for dementia in primary care. METHODS: We will conduct a prospective diagnostic test accuracy study to evaluate the accuracy of a range of simple tests for diagnosing all-cause-dementia in symptomatic people aged over 70 years who have consulted with their general practitioner (GP). We will invite eligible people to attend a research clinic where they will undergo a range of index tests that a GP could perform in the surgery and also be assessed by a specialist in memory disorders at the same appointment. Participating GPs will request neuroimaging and blood tests and otherwise manage patients in line with their usual clinical practice. The reference standard will be the consensus judgement of three experts (neurologist, psychiatrist and geriatrician) based on information from the specialist assessment, GP records and investigations, but not including items in the index test battery. The target condition will be all-cause dementia but we will also investigate diagnostic accuracy for sub-types where possible. We will use qualitative interviews with patients and focus groups with clinicians to help us understand the acceptability and feasibility of diagnosing dementia in primary care using the tests that we are investigating. DISCUSSION: Our results will help clinicians decide on which tests to perform in someone where there is concern about possible dementia and inform commissioning of diagnostic pathways. BioMed Central 2016-07-19 /pmc/articles/PMC4950265/ /pubmed/27430736 http://dx.doi.org/10.1186/s12875-016-0475-2 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Creavin, Sam T.
Cullum, Sarah J.
Haworth, Judy
Wye, Lesley
Bayer, Antony
Fish, Mark
Purdy, Sarah
Ben-Shlomo, Yoav
Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol
title Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol
title_full Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol
title_fullStr Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol
title_full_unstemmed Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol
title_short Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol
title_sort towards improving diagnosis of memory loss in general practice: timeli diagnostic test accuracy study protocol
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4950265/
https://www.ncbi.nlm.nih.gov/pubmed/27430736
http://dx.doi.org/10.1186/s12875-016-0475-2
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