Comparing a Single Clinician Versus a Multidisciplinary Consensus Conference Approach for Dementia Diagnostics
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Comparing a Single Clinician Versus a Multidisciplinary Consensus Conference Approach for Dementia Diagnostics. / Thorlacius-Ussing, Gorm; Bruun, Marie; Gjerum, Le; Frederiksen, Kristian S.; Rhodius-Meester, Hanneke F.M.; Van Der Flier, Wiesje M.; Waldemar, Gunhild; Hasselbalch, Steen G.
I: Journal of Alzheimer's Disease, Bind 83, Nr. 2, 2021, s. 741-751.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Comparing a Single Clinician Versus a Multidisciplinary Consensus Conference Approach for Dementia Diagnostics
AU - Thorlacius-Ussing, Gorm
AU - Bruun, Marie
AU - Gjerum, Le
AU - Frederiksen, Kristian S.
AU - Rhodius-Meester, Hanneke F.M.
AU - Van Der Flier, Wiesje M.
AU - Waldemar, Gunhild
AU - Hasselbalch, Steen G.
N1 - Publisher Copyright: © 2021 - The authors.
PY - 2021
Y1 - 2021
N2 - Background: Evidence-based recommendations on the optimal evaluation approach for dementia diagnostics are limited. This impedes a harmonized workup across clinics and nations. Objective: To evaluate the diagnostic performance of a multidisciplinary consensus conference compared to a single clinician approach. Methods: In this prospective study, we enrolled 457 patients with suspected cognitive decline, from two European memory clinics. A diagnostic evaluation was performed at baseline independently in two ways: 1) by a single clinician and 2) at a multidisciplinary consensus conference. A syndrome diagnosis and an etiological diagnosis was made. The confidence in the diagnosis was recorded using a visual analogue scale. An expert panel re-evaluation diagnosis served as reference for the baseline syndrome diagnosis and a 12-24-month follow-up diagnosis for the etiological diagnosis. Results: 439 patients completed the study. We observed 12.5%discrepancy (k=0.81) comparing the baseline syndrome diagnoses of the single clinician to the consensus conference, and 22.3%discrepancy (k=0.68) for the baseline etiological diagnosis. The accuracy of the baseline etiological diagnosis was significantly higher at the consensus conference and was driven mainly by increased accuracy in the MCI group. Confidence in the etiological diagnosis at baseline was significantly higher at the consensus conference (p<0.005), especially for the frontotemporal dementia diagnosis. Conclusion: The multidisciplinary consensus conference performed better on diagnostic accuracy of disease etiology and increased clinicians' confidence. This highlights the importance of a multidisciplinary diagnostic evaluation approach for dementia diagnostics, especially when evaluating patients in the MCI stage.
AB - Background: Evidence-based recommendations on the optimal evaluation approach for dementia diagnostics are limited. This impedes a harmonized workup across clinics and nations. Objective: To evaluate the diagnostic performance of a multidisciplinary consensus conference compared to a single clinician approach. Methods: In this prospective study, we enrolled 457 patients with suspected cognitive decline, from two European memory clinics. A diagnostic evaluation was performed at baseline independently in two ways: 1) by a single clinician and 2) at a multidisciplinary consensus conference. A syndrome diagnosis and an etiological diagnosis was made. The confidence in the diagnosis was recorded using a visual analogue scale. An expert panel re-evaluation diagnosis served as reference for the baseline syndrome diagnosis and a 12-24-month follow-up diagnosis for the etiological diagnosis. Results: 439 patients completed the study. We observed 12.5%discrepancy (k=0.81) comparing the baseline syndrome diagnoses of the single clinician to the consensus conference, and 22.3%discrepancy (k=0.68) for the baseline etiological diagnosis. The accuracy of the baseline etiological diagnosis was significantly higher at the consensus conference and was driven mainly by increased accuracy in the MCI group. Confidence in the etiological diagnosis at baseline was significantly higher at the consensus conference (p<0.005), especially for the frontotemporal dementia diagnosis. Conclusion: The multidisciplinary consensus conference performed better on diagnostic accuracy of disease etiology and increased clinicians' confidence. This highlights the importance of a multidisciplinary diagnostic evaluation approach for dementia diagnostics, especially when evaluating patients in the MCI stage.
KW - Alzheimer disease
KW - clinical decision-making
KW - dementia
KW - differential diagnosis
KW - frontotemporal dementia
KW - Lewy body disease
KW - vascular dementia
U2 - 10.3233/JAD-210278
DO - 10.3233/JAD-210278
M3 - Journal article
C2 - 34366342
AN - SCOPUS:85115271252
VL - 83
SP - 741
EP - 751
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
SN - 1387-2877
IS - 2
ER -
ID: 301628081