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Validation of consensus panel diagnosis in dementia
Matthew J Gabel1, Norman L Foster, Judith L Heidebrink
1Department of Political Science, Washington University, St Louis, MO 63130-4899, USA. mgabel@artsci.wustl.edu
Archives of Neurology
|December 15, 2010
Summary
Consensus panels using a modified Delphi protocol improved diagnostic accuracy and certainty for dementing diseases, especially when expert opinions varied. This method offers a reliable alternative to pathologic findings in clinical and research settings.
Area of Science:
- Neurology
- Medical Imaging
- Decision Science
Background:
- Clinical diagnosis of dementing diseases relies on subjective symptom interpretation.
- Consensus panels are used for diagnoses when pathologic findings are absent.
- Group decision-making factors can negatively impact panel performance.
Purpose of the Study:
- To identify conditions that enhance consensus panel diagnoses.
- To evaluate the diagnostic utility of fludeoxyglucose F 18 positron emission tomography (FDG-PET).
Main Methods:
- Compared neuropathologic diagnoses with individual and consensus panel diagnoses.
- Utilized clinical scenarios, FDG-PET images, or both.
- Employed a modified Delphi method with expert and trainee panels for 45 patients with Alzheimer disease or frontotemporal dementia.
Main Results:
- Consensus protocols surpassed individual expert accuracy when clinical information led to diverse judgments.
- Consensus was 3.5 times more likely to improve accuracy and diagnostic certainty.
- Forced group consensus rules performed as well as majority or unanimity rules.
Conclusions:
- A modified Delphi protocol for consensus diagnosis is a viable substitute for pathologic information.
- This protocol enhances diagnostic accuracy and certainty when panelist judgments differ.
- The method is adaptable to various research and clinical settings, mitigating group decision-making risks.
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