![]() formal carers or relatives) with sufficient knowledge of the patient as a means of identifying any temporal change in cognition and related function. An attractive approach is to use informants (e.g. As dementia progresses, insight is often lost and it can be challenging to obtain evidence of cognitive changes from the patient themselves. Such a process provides a ‘snapshot’ of cognitive function and does not capture cognitive decline yet, this is a key component of the dementia diagnosis. Various tools are available to screen for cognitive impairment the most common of which directly assess a person’s cognition via questions and/or ‘pencil and paper’ tasks. In practice, a two-stage process is typically employed, with an initial screening process-often carried out by non-specialists-that is used to identify those that require a more detailed assessment from a specialist. Thus, the ‘ideal’ approach to assessment is only feasible for a small proportion of the potential population affected. However, this time-consuming approach requires specialist hospital-based services that are a limited resource in high-income countries. The ideal method for diagnosing dementia involves comprehensive multidisciplinary assessment informed by supplementary information such as neuropsychological testing, neuroimaging or tissue biomarkers. The key to the effective management of dementia is early diagnosis. Depending upon the case definition applied, global prevalence of dementia is estimated to be 50 million. It will also apply network meta-analysis techniques to a new area.ĭementia is a prevalent and ever-increasing public health issue. Our overview of systematic reviews will provide a concise summary of the diagnostic test accuracy of informant tools and highlight areas where evidence is currently lacking in this regard. If data allow, we will perform a statistical comparison of the diagnostic test accuracy of each informant questionnaire using a network approach. We will pool sensitivity and specificity data via meta-analysis to generate a diagnostic test accuracy summary statistic for each informant questionnaire. We will collate the identified reviews to create an ‘evidence map’ that highlights where evidence does and does not exist in relation to informant questionnaires. We will assess review quality using the AMSTAR-2 (Assessment of Multiple Systematic Reviews) and assess reporting quality using PRISMA-DTA (Preferred Reporting Items for Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies) checklists. We will search 6 databases (EMBASE (OVID) Health and Psychosocial Instruments (OVID) Medline (OVID) CINAHL (EBSCO) PSYCHinfo (EBSCO) and the PROSPERO registry of review protocols) to identify systematic reviews that describe the diagnostic test accuracy of informant questionnaires for dementia. We will create a list of informant tools by consulting with dementia experts. As an overview of systematic reviews of test accuracy is a relatively novel approach, we will use this review to explore methods for visual representation of complex data, for highlighting evidence gaps and for indirect comparative analyses. We will conduct an overview of systematic reviews in which we ‘review the systematic reviews’ of diagnostic test accuracy studies evaluating informant questionnaires for dementia. A key aim of the overview of systematic reviews is to present a disparate evidence base in a single, easy to access platform. However, most reviews to date have focused on a single diagnostic tool and this does not address which tool is ‘best’. ![]() Recent systematic reviews have sought to establish the diagnostic test accuracy of various dementia informant screening tools. Informant questionnaires are frequently used to assess for dementia in clinical practice. ![]() Robust diagnosis of dementia requires an understanding of the accuracy of the available diagnostic tests.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |