Development of international practice recommendations for the recognition and management of hearing, vision and cognitive impairment
Bibliographic record
Abstract
Abstract Background Unrecognised hearing and vision impairment complicates the assessment and management of people living with dementia (PwD). Hearing and vision impairment may be more likely to go unrecognised among PwD, because PwD may be less likely to recognise and report difficulties. Communication difficulties and behaviours that challenge in PwD may be wrongly attributed to cognitive impairment by carers and clinicians, when actually they are the consequence of remediable sensory loss. Despite these issues, practice recommendations for recognition and management of hearing, vision and cognitive impairment are non‐existent. The aim was to develop internationally relevant, multi‐disciplinary practice recommendations for professionals involved in the diagnosis, care and management of older people with concurrent cognitive, hearing and/or vision impairment. Method The International Hearing, Vision and Dementia Practice Recommendations’ Task Force consisted of 16 interdisciplinary professionals from Europe, Australia, Canada and the USA. We adapted core elements of the Who Handbook for Guideline Development as it allows for flexibility to develop evidence‐based practice recommendations considering benefits and limitations of the existing evidence while emphasising the need for individualised professional judgement. Three phases were involved in the development of the guidance, (1) collating existing evidence; (2) filling the gaps in evidence; (3) refining the final list of recommendations. Phases 1 to 3 encompassed various methodologies including a review of existing guidelines within the three clinical domains, systematic reviews, qualitative studies, expert reference groups, clinical professional consortium, and consensus meetings. Recommendations were developed with the input of clinical and lay stakeholders. Result A consensus was reached on 16 recommendations, classified into six domains regarding Awareness and Knowledge, Recognition and Detection, Evaluation, Management, Support and Policy. Conclusion This is the first set of international, interdisciplinary practice recommendations regarding care of concurrent cognitive, hearing and/or vision impairment in older people. These recommendations may help guide development of services and policy to improve the lives of older people with dual or triple impairments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.145 | 0.286 |
| Meta-epidemiology (narrow) | 0.003 | 0.003 |
| Meta-epidemiology (broad) | 0.005 | 0.011 |
| Bibliometrics | 0.020 | 0.013 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.009 | 0.010 |
| Open science | 0.013 | 0.011 |
| Research integrity | 0.016 | 0.013 |
| Insufficient payload (model declined to judge) | 0.008 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".