Literature DB >> 30605060

Impact of a Clinical Decision Support Tool on Dementia Diagnostics in Memory Clinics: The PredictND Validation Study.

Marie Bruun1, Kristian S Frederiksen1, Hanneke F M Rhodius-Meester2, Marta Baroni3, Le Gjerum1, Juha Koikkalainen4, Timo Urhemaa5, Antti Tolonen5, Mark van Gils5, Tong Tong6, Ricardo Guerrero6, Daniel Rueckert6, Nadia Dyremose1, Birgitte Bo Andersen1, Anja H Simonsen1, Afina Lemstra2, Merja Hallikainen7, Sudhir Kurl7, Sanna-Kaisa Herukka7, Anne M Remes7,8, Gunhild Waldemar1, Hilkka Soininen7, Patrizia Mecocci3, Wiesje M van der Flier2,9, Jyrki Lötjönen4, Steen G Hasselbalch1.   

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. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Entities:  

Keywords:  Alzheimer´s disease; CDSS; Computer-assisted diagnosis; Dementia with Lewy body; Frontotemporalzzm321990disease; Vascular dementia; differential diagnosis; neurodegenerative disease.

Mesh：

Year:  2019        PMID： 30605060     DOI： 10.2174/1567205016666190103152425

Source DB:  PubMed          Journal:  Curr Alzheimer Res        ISSN： 1567-2050            Impact factor:   3.498


  10 in total

1.  cCOG: A web-based cognitive test tool for detecting neurodegenerative disorders.

Authors:  Hanneke F M Rhodius-Meester; Teemu Paajanen; Juha Koikkalainen; Shadi Mahdiani; Marie Bruun; Marta Baroni; Afina W Lemstra; Philip Scheltens; Sanna-Kaisa Herukka; Maria Pikkarainen; Anette Hall; Tuomo Hänninen; Tiia Ngandu; Miia Kivipelto; Mark van Gils; Steen Gregers Hasselbalch; Patrizia Mecocci; Anne Remes; Hilkka Soininen; Wiesje M van der Flier; Jyrki Lötjönen
Journal:  Alzheimers Dement (Amst)       Date:  2020-08-25

2.  Prognostic value of complementary biomarkers of neurodegeneration in a mixed memory clinic cohort.

Authors:  Mathias Holsey Gramkow; Le Gjerum; Juha Koikkalainen; Jyrki Lötjönen; Ian Law; Steen Gregers Hasselbalch; Gunhild Waldemar; Kristian Steen Frederiksen
Journal:  PeerJ       Date:  2020-07-09       Impact factor: 2.984

3.  Detecting frontotemporal dementia syndromes using MRI biomarkers.

Authors:  Marie Bruun; Juha Koikkalainen; Hanneke F M Rhodius-Meester; Marta Baroni; Le Gjerum; Mark van Gils; Hilkka Soininen; Anne M Remes; Päivi Hartikainen; Gunhild Waldemar; Patrizia Mecocci; Frederik Barkhof; Yolande Pijnenburg; Wiesje M van der Flier; Steen G Hasselbalch; Jyrki Lötjönen; Kristian S Frederiksen
Journal:  Neuroimage Clin       Date:  2019-02-04       Impact factor: 4.881

4.  Selection of memory clinic patients for CSF biomarker assessment can be restricted to a quarter of cases by using computerized decision support, without compromising diagnostic accuracy.

Authors:  Hanneke F M Rhodius-Meester; Ingrid S van Maurik; Juha Koikkalainen; Antti Tolonen; Kristian S Frederiksen; Steen G Hasselbalch; Hilkka Soininen; Sanna-Kaisa Herukka; Anne M Remes; Charlotte E Teunissen; Frederik Barkhof; Yolande A L Pijnenburg; Philip Scheltens; Jyrki Lötjönen; Wiesje M van der Flier
Journal:  PLoS One       Date:  2020-01-15       Impact factor: 3.240

5.  Use of a Decision Support Tool on Prognosis of Work Ability in Work Disability Assessments: An Experimental Study Among Insurance Physicians.

Authors:  I Louwerse; M A Huysmans; H J van Rijssen; C L I Gielen; A J van der Beek; J R Anema
Journal:  J Occup Rehabil       Date:  2021-03

6.  Comparison of the clinical impact of 2-[18F]FDG-PET and cerebrospinal fluid biomarkers in patients suspected of Alzheimer's disease.

Authors:  Le Gjerum; Birgitte Bo Andersen; Marie Bruun; Anja Hviid Simonsen; Otto Mølby Henriksen; Ian Law; Steen Gregers Hasselbalch; Kristian Steen Frederiksen
Journal:  PLoS One       Date:  2021-03-12       Impact factor: 3.240

7.  Development and design of a diagnostic report to support communication in dementia: Co-creation with patients and care partners.

Authors:  Aniek M van Gils; Leonie N C Visser; Heleen M A Hendriksen; Jean Georges; Wiesje M van der Flier; Hanneke F M Rhodius-Meester
Journal:  Alzheimers Dement (Amst)       Date:  2022-09-06

8.  Evaluating 2-[18F]FDG-PET in differential diagnosis of dementia using a data-driven decision model.

Authors:  Le Gjerum; Kristian Steen Frederiksen; Otto Mølby Henriksen; Ian Law; Marie Bruun; Anja Hviid Simonsen; Patrizia Mecocci; Marta Baroni; Massimo Eugenio Dottorini; Juha Koikkalainen; Jyrki Lötjönen; Steen Gregers Hasselbalch
Journal:  Neuroimage Clin       Date:  2020-04-24       Impact factor: 4.881

9.  Assessing the Views of Professionals, Patients, and Care Partners Concerning the Use of Computer Tools in Memory Clinics: International Survey Study.

Authors:  Aniek M van Gils; Leonie Nc Visser; Heleen Ma Hendriksen; Jean Georges; Majon Muller; Femke H Bouwman; Wiesje M van der Flier; Hanneke Fm Rhodius-Meester
Journal:  JMIR Form Res       Date:  2021-12-03

10.  Comparing a Single Clinician Versus a Multidisciplinary Consensus Conference Approach for Dementia Diagnostics.

Authors:  Gorm Thorlacius-Ussing; Marie Bruun; Le Gjerum; Kristian S Frederiksen; Hanneke F M Rhodius-Meester; Wiesje M van der Flier; Gunhild Waldemar; Steen G Hasselbalch
Journal:  J Alzheimers Dis       Date:  2021       Impact factor: 4.472
  10 in total

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