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Related Concept Videos

Documentation of Nursing Diagnosis01:10

Documentation of Nursing Diagnosis

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The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
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Methods of Documentation VI: Case Management Model01:15

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The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
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Dementia01:30

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Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
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The nursing process provides a clinical decision-making framework for patients and families to establish and implement a personalized care plan. Since part of the nurse's duties is to teach patients, the steps of the nursing process are the most effective way to approach instruction. The nursing process and the teaching-learning process are inextricably linked.
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Nursing Clinical Information System01:27

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Nursing Clinical Information System (NCIS)
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
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Alzheimer's Disease: Treatment01:22

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Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
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Related Experiment Video

Updated: Jun 6, 2025

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
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Computerized decision support to optimally funnel patients through the diagnostic pathway for dementia.

Aniek M van Gils1,2, Antti Tolonen3, Argonde C van Harten4,5

  • 1Alzheimer Center Amsterdam and Department of Neurology, VU University Medical Center, Amsterdam UMC, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands. a.vangils@amsterdamumc.nl.

Alzheimer'S Research & Therapy
|November 26, 2024
PubMed
Summary

A data-driven approach efficiently guides dementia diagnosis and treatment eligibility. This stepwise testing optimizes diagnostic pathways, improving accuracy and reducing unnecessary tests for memory clinic patients.

Keywords:
Alzheimer’s diseaseData-driven diagnosisDifferential diagnosisEligibility

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Area of Science:

  • Neurology
  • Biomarkers
  • Diagnostic Tools

Background:

  • Rising dementia prevalence necessitates efficient diagnostic strategies.
  • Emerging disease-modifying therapies (DMTs) require precise patient selection.
  • Memory clinics need optimized pathways for syndrome, etiological, and DMT eligibility diagnosis.

Purpose of the Study:

  • To develop and validate a data-driven, stepwise approach for dementia diagnosis.
  • To assess the efficiency and accuracy of this approach across three clinical scenarios.
  • To guide clinicians in selecting tests with added value in memory clinics.

Main Methods:

  • Utilized data from two memory clinic cohorts (ADC, PredictND) comprising 504 dementia patients, 191 MCI, and 188 controls.
  • Employed digital cognitive screening (cCOG), neuropsychological assessment (NP), MRI, and CSF biomarkers in a sequential testing strategy.
  • A clinical decision support system (CDSS) generated a disease state index (DSI) to guide diagnostic certainty and confirm diagnoses.

Main Results:

  • cCOG prescreening reduced NP needs by 42% for syndrome diagnosis (accuracy 0.71).
  • Stepwise etiological diagnosis achieved 80% accuracy, requiring MRI in 77% and CSF in 37% of cases.
  • For DMT eligibility, stepwise testing identified 90% of potentially eligible AD dementia patients, with 60% proceeding to CSF testing.

Conclusions:

  • Data-driven diagnostic pathways are accurate and efficient across different clinical scenarios.
  • A CDSS tool can assist clinicians in optimizing test selection for added value.
  • Efficient diagnostic pathways are crucial for maintaining accessibility and affordability of dementia care, especially with new DMTs.