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

Research output: Contribution to journalArticle

Original languageEnglish
Article number79
Number of pages10
JournalBMC Family Practice
Volume17
Issue number1
DOIs
DateAccepted/In press - 20 Jun 2016
DatePublished (current) - 19 Jul 2016

Abstract

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.

    Research areas

  • Dementia, Diagnostic tests, General practice, Primary care, Sensitivity and specificity

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    Rights statement: This is the final published version of the article (version of record). It first appeared online via BioMed Central at http://bmcfampract.biomedcentral.com/articles/10.1186/s12875-016-0475-2. Please refer to any applicable terms of use of the publisher.

    Final published version, 824 KB, PDF document

    Licence: CC BY

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