Red flags for remote cognitive assessment: An expert consensus study using the Delphi method on behalf of the Canadian Consortium on Neurodegeneration in Aging
Notice bibliographique
Résumé
Abstract Remote cognitive diagnostic assessment offers numerous benefits, including increased access to care, but it may not always be appropriate, and guidelines are lacking. Our goal was to develop a clinical tool to determine a patient’s suitability for undergoing remote cognitive assessment. A multidisciplinary workgroup, composed of experts in remote assessment, was convened under the auspices of the Canadian Consortium on Neurodegeneration in Aging. Delphi, an anonymous group consensus method, was used to determine ‘red flags’ for remote cognitive diagnostic assessment. The process consisted of one round of flag generation, then two rounds of flag scoring based on effectiveness, reproducibility, and efficiency. In the first round, 11 respondents generated 67 potential flags. In subsequent rounds, 8 and 9 respondents, respectively, scored the flags, yielding 14 red flags that met the predetermined consensus criteria. This research led to the creation of a novel clinical decision-making infographic to support multidisciplinary clinicians in determining a patient’s readiness to undergo remote cognitive and behavioral diagnostic assessment. Highlights A timely and accessible diagnosis of dementia is crucial for optimal patient care. Although clinicians are increasingly using telemedicine, guidelines on patient suitability for remote cognitive and behavioral assessment are lacking. To address this knowledge gap, we developed a clinical decision-making tool to determine if a cognitive evaluation via telemedicine should be avoided. To synthesize expert opinion, we used the Delphi method, an anonymous group consensus method that reduces eminence bias. In collaboration with knowledge translation experts, an infographic describing the final 14 red flags for remote cognitive assessment was developed for clinicians to determine the appropriateness of patients for remote dementia diagnostic assessment. Research in context Systematic Review PubMed and Google Scholar were used to survey the literature. Our review found that although there was a need for better access to dementia care, a framework to provide such care remotely is in development. We identified a gap in clinical guidelines on contraindications for remote cognitive assessment. Interpretation This study created a clinical decision-making tool as an accessible infographic for clinicians to use when considering a remote cognitive diagnostic assessment. This guideline is based on expert consensus. Future Directions In future studies, patient and caregiver perspectives should be incorporated into the decision-making process, and this tool should be validated in clinical contexts. Some of the identified flags for remote assessment are modifiable, and strategies to mitigate burden on patients and caregivers are warranted.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».