Impact of a clinical decision support tool on dementia diagnostics in memory clinics: The predictnd validation study
Bruun M, Frederiksen KS, Rhodius-Meester HFM, Baroni M, Gjerum L, Koikkalainen J, Urhemaa T, Tolonen A, Van Gils M, Tong T, Guerrero R, Rueckert D, Dyremose N, Andersen BB, Simonsen AH, Lemstra A, Hallikainen M, Kurl S, Herukka SK, Remes AM, Waldemar G, Soininen H, Mecocci P, Van Der Flier WM, Lotjonen J, Hasselbalch SG (2019)
Publication Type: Journal article
Publication year: 2019
Journal
Book Volume: 16
Pages Range: 91-101
Journal Issue: 2
DOI: 10.2174/1567205016666190103152425
Abstract
Background: Determining the underlying etiology of dementia can be challenging. Computer- based Clinical Decision Support Systems (CDSS) have the potential to provide an objective comparison of data and assist clinicians. Objectives: To assess the diagnostic impact of a CDSS, the PredictND tool, for differential diagnosis of dementia in memory clinics. Methods: In this prospective multicenter study, we recruited 779 patients with either subjective cognitive decline (n=252), mild cognitive impairment (n=219) or any type of dementia (n=274) and followed them for minimum 12 months. Based on all available patient baseline data (demographics, neuropsychological tests, cerebrospinal fluid biomarkers, and MRI visual and computed ratings), the PredictND tool provides a comprehensive overview and analysis of the data with a likelihood index for five diagnostic groups; Alzheimer´s disease, vascular dementia, dementia with Lewy bodies, frontotemporal dementia and subjective cognitive decline. At baseline, a clinician defined an etiological diagnosis and confidence in the diagnosis, first without and subsequently with the PredictND tool. The follow-up diagnosis was used as the reference diagnosis. Results: In total, 747 patients completed the follow-up visits (53% female, 69±10 years). The etiological diagnosis changed in 13% of all cases when using the PredictND tool, but the diagnostic accuracy did not change significantly. Confidence in the diagnosis, measured by a visual analogue scale (VAS, 0-100%) increased (ΔVAS=3.0%, p<0.0001), especially in correctly changed diagnoses (ΔVAS=7.2%, p=0.0011). Conclusion: Adding the PredictND tool to the diagnostic evaluation affected the diagnosis and increased clinicians’ confidence in the diagnosis indicating that CDSSs could aid clinicians in the differential diagnosis of dementia.
Involved external institutions
University of Copenhagen
Denmark (DK)
Università degli Studi di Perugia
Italy (IT)
Vrije Universiteit Amsterdam (VU) / University Amsterdam
Netherlands (NL)
Combinostics Oy
Finland (FI)
VTT Technical Research Centre of Finland
Finland (FI)
University College London (UCL)
United Kingdom (GB)
University of Eastern Finland
Finland (FI)
Denmark (DK)
Università degli Studi di Perugia
Italy (IT)
Vrije Universiteit Amsterdam (VU) / University Amsterdam
Netherlands (NL)
Combinostics Oy
Finland (FI)
VTT Technical Research Centre of Finland
Finland (FI)
University College London (UCL)
United Kingdom (GB)
University of Eastern Finland
Finland (FI)
How to cite
APA:
Bruun, M., Frederiksen, K.S., Rhodius-Meester, H.F.M., Baroni, M., Gjerum, L., Koikkalainen, J.,... Hasselbalch, S.G. (2019). Impact of a clinical decision support tool on dementia diagnostics in memory clinics: The predictnd validation study. Current Alzheimer Research, 16(2), 91-101. https://doi.org/10.2174/1567205016666190103152425
MLA:
Bruun, Marie, et al. "Impact of a clinical decision support tool on dementia diagnostics in memory clinics: The predictnd validation study." Current Alzheimer Research 16.2 (2019): 91-101.
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