The Use of a Computerized Cognitive Assessment to Improve the Efficiency of Primary Care Referrals to Memory Services: Protocol for the Accelerating Dementia Pathway Technologies (ADePT) Study

BackgroundExisting primary care cognitive assessment tools are crude or time-consuming screening instruments which can only detect cognitive impairment when it is well established. Due to the COVID-19 pandemic, memory services have adapted to the new environment by moving to...

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Main Authors: Chris Kalafatis, Mohammad Hadi Modarres, Panos Apostolou, Naji Tabet, Seyed-Mahdi Khaligh-Razavi
Format: Article
Language:English
Published: JMIR Publications 2022-01-01
Series:JMIR Research Protocols
Online Access:https://www.researchprotocols.org/2022/1/e34475
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author Chris Kalafatis
Mohammad Hadi Modarres
Panos Apostolou
Naji Tabet
Seyed-Mahdi Khaligh-Razavi
author_facet Chris Kalafatis
Mohammad Hadi Modarres
Panos Apostolou
Naji Tabet
Seyed-Mahdi Khaligh-Razavi
author_sort Chris Kalafatis
collection DOAJ
description BackgroundExisting primary care cognitive assessment tools are crude or time-consuming screening instruments which can only detect cognitive impairment when it is well established. Due to the COVID-19 pandemic, memory services have adapted to the new environment by moving to remote patient assessments to continue meeting service user demand. However, the remote use of cognitive assessments has been variable while there has been scant evaluation of the outcome of such a change in clinical practice. Emerging research in remote memory clinics has highlighted computerized cognitive tests, such as the Integrated Cognitive Assessment (ICA), as prominent candidates for adoption in clinical practice both during the pandemic and for post-COVID-19 implementation as part of health care innovation. ObjectiveThe aim of the Accelerating Dementia Pathway Technologies (ADePT) study is to develop a real-world evidence basis to support the adoption of ICA as an inexpensive screening tool for the detection of cognitive impairment to improve the efficiency of the dementia care pathway. MethodsPatients who have been referred to a memory clinic by a general practitioner (GP) are recruited. Participants complete the ICA either at home or in the clinic along with medical history and usability questionnaires. The GP referral and ICA outcome are compared with the specialist diagnosis obtained at the memory clinic. The clinical outcomes as well as National Health Service reference costing data will be used to assess the potential health and economic benefits of the use of the ICA in the dementia diagnosis pathway. ResultsThe ADePT study was funded in January 2020 by Innovate UK (Project Number 105837). As of September 2021, 86 participants have been recruited in the study, with 23 participants also completing a retest visit. Initially, the study was designed for in-person visits at the memory clinic; however, in light of the COVID-19 pandemic, the study was amended to allow remote as well as face-to-face visits. The study was also expanded from a single site to 4 sites in the United Kingdom. We expect results to be published by the second quarter of 2022. ConclusionsThe ADePT study aims to improve the efficiency of the dementia care pathway at its very beginning and supports systems integration at the intersection between primary and secondary care. The introduction of a standardized, self-administered, digital assessment tool for the timely detection of neurodegeneration as part of a decision support system that can signpost accordingly can reduce unnecessary referrals, service backlog, and assessment variability. Trial RegistrationISRCTN 16596456; https://www.isrctn.com/ISRCTN16596456 International Registered Report Identifier (IRRID)DERR1-10.2196/34475
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spelling doaj.art-6509ca77bb084448ae8ce3dca82a0c482023-08-28T20:27:27ZengJMIR PublicationsJMIR Research Protocols1929-07482022-01-01111e3447510.2196/34475The Use of a Computerized Cognitive Assessment to Improve the Efficiency of Primary Care Referrals to Memory Services: Protocol for the Accelerating Dementia Pathway Technologies (ADePT) StudyChris Kalafatishttps://orcid.org/0000-0002-7171-5391Mohammad Hadi Modarreshttps://orcid.org/0000-0002-9579-7942Panos Apostolouhttps://orcid.org/0000-0001-6367-7260Naji Tabethttps://orcid.org/0000-0003-4629-6196Seyed-Mahdi Khaligh-Razavihttps://orcid.org/0000-0002-5700-1704 BackgroundExisting primary care cognitive assessment tools are crude or time-consuming screening instruments which can only detect cognitive impairment when it is well established. Due to the COVID-19 pandemic, memory services have adapted to the new environment by moving to remote patient assessments to continue meeting service user demand. However, the remote use of cognitive assessments has been variable while there has been scant evaluation of the outcome of such a change in clinical practice. Emerging research in remote memory clinics has highlighted computerized cognitive tests, such as the Integrated Cognitive Assessment (ICA), as prominent candidates for adoption in clinical practice both during the pandemic and for post-COVID-19 implementation as part of health care innovation. ObjectiveThe aim of the Accelerating Dementia Pathway Technologies (ADePT) study is to develop a real-world evidence basis to support the adoption of ICA as an inexpensive screening tool for the detection of cognitive impairment to improve the efficiency of the dementia care pathway. MethodsPatients who have been referred to a memory clinic by a general practitioner (GP) are recruited. Participants complete the ICA either at home or in the clinic along with medical history and usability questionnaires. The GP referral and ICA outcome are compared with the specialist diagnosis obtained at the memory clinic. The clinical outcomes as well as National Health Service reference costing data will be used to assess the potential health and economic benefits of the use of the ICA in the dementia diagnosis pathway. ResultsThe ADePT study was funded in January 2020 by Innovate UK (Project Number 105837). As of September 2021, 86 participants have been recruited in the study, with 23 participants also completing a retest visit. Initially, the study was designed for in-person visits at the memory clinic; however, in light of the COVID-19 pandemic, the study was amended to allow remote as well as face-to-face visits. The study was also expanded from a single site to 4 sites in the United Kingdom. We expect results to be published by the second quarter of 2022. ConclusionsThe ADePT study aims to improve the efficiency of the dementia care pathway at its very beginning and supports systems integration at the intersection between primary and secondary care. The introduction of a standardized, self-administered, digital assessment tool for the timely detection of neurodegeneration as part of a decision support system that can signpost accordingly can reduce unnecessary referrals, service backlog, and assessment variability. Trial RegistrationISRCTN 16596456; https://www.isrctn.com/ISRCTN16596456 International Registered Report Identifier (IRRID)DERR1-10.2196/34475https://www.researchprotocols.org/2022/1/e34475
spellingShingle Chris Kalafatis
Mohammad Hadi Modarres
Panos Apostolou
Naji Tabet
Seyed-Mahdi Khaligh-Razavi
The Use of a Computerized Cognitive Assessment to Improve the Efficiency of Primary Care Referrals to Memory Services: Protocol for the Accelerating Dementia Pathway Technologies (ADePT) Study
JMIR Research Protocols
title The Use of a Computerized Cognitive Assessment to Improve the Efficiency of Primary Care Referrals to Memory Services: Protocol for the Accelerating Dementia Pathway Technologies (ADePT) Study
title_full The Use of a Computerized Cognitive Assessment to Improve the Efficiency of Primary Care Referrals to Memory Services: Protocol for the Accelerating Dementia Pathway Technologies (ADePT) Study
title_fullStr The Use of a Computerized Cognitive Assessment to Improve the Efficiency of Primary Care Referrals to Memory Services: Protocol for the Accelerating Dementia Pathway Technologies (ADePT) Study
title_full_unstemmed The Use of a Computerized Cognitive Assessment to Improve the Efficiency of Primary Care Referrals to Memory Services: Protocol for the Accelerating Dementia Pathway Technologies (ADePT) Study
title_short The Use of a Computerized Cognitive Assessment to Improve the Efficiency of Primary Care Referrals to Memory Services: Protocol for the Accelerating Dementia Pathway Technologies (ADePT) Study
title_sort use of a computerized cognitive assessment to improve the efficiency of primary care referrals to memory services protocol for the accelerating dementia pathway technologies adept study
url https://www.researchprotocols.org/2022/1/e34475
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