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

Kalafatis, Chris, Modarres, Mohammad Hadi, Apostolou, Panos, Tabet, Naji and Khaligh-Razavi, Seyed-Mahdi (2022) 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, 11 (1). e34475. ISSN 1929-0748

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Abstract

Background:
Existing 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.

Objective:
The 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.

Methods:
Patients 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.

Results:
The 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.

Conclusions:
The 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.

Item Type: Article
Keywords: COVID-19, artificial intelligence, assessment, cognition, cognitive assessment, dementia, detection, diagnosis, early diagnosis, efficiency, general practice, impairment, memory, mental health, primary health care, screening
Schools and Departments: Brighton and Sussex Medical School > Neuroscience
SWORD Depositor: Mx Elements Account
Depositing User: Mx Elements Account
Date Deposited: 12 Jul 2022 15:42
Last Modified: 12 Jul 2022 15:45
URI: http://sro.sussex.ac.uk/id/eprint/106903

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