改善早期痴呆症检测在多样化的老年人与认知问题与5-Cog范式:混合有效性实施临床试验的协议
Rachel Beth Rosansky Chalmer1, Emmeline Ayers2, Erica F Weiss3
1Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States.
JMIR research protocols
|April 3, 2025
概括
5Cog模式,简短的认知评估,有效地帮助在初级保健中早期发现痴呆症. 本研究评估了其对各种老年患者的实际有效性,实施和成本效益.
科学领域:
- 老年学是一门学科.
- 认知神经学 认知神经学
- 主要护理医学 医疗保健
背景情况:
- 5Cog范式是一个5分钟的认知评估工具,提供决策支持,以提高对老年初级保健患者认知障碍 (包括痴呆症) 的早期检测.
- 它使用基于图像和符号的评估和问卷,旨在低成本,简单,并最大限度地减少识字和文化偏见.
- 综合决策支持旨在指导对异常评估结果的适当临床反应.
研究的目的:
- 评估5-Cog模式在增加轻度认知障碍或痴呆症新诊断率方面的有效性.
- 评估在初级保健机构中实施5Cog范式的过程,背景和结果.
- 从社会和付款人的角度检查5Cog范式的成本效益.
主要方法:
- 一个混合型1有效性实施试验,涉及6600名在纽约和印第安纳州22家初级保健诊所的认知问题老年患者.
- 一个务实的,集群随机临床试验设计,以分析5-Cog范式在新诊断上的有效性.
- 混合方法 (调查,采访) 使用实施研究综合框架来分析实施,并进行成本效益分析,估计每项额外痴呆症诊断的成本.
主要成果:
- 一项验证研究确定了5-Cog电池组件的切割分数,最初招募的76名患者的诊断包括痴呆症 (42%) 和轻度认知障碍 (37%).
- 截至2024年12月,12家诊所完成了登陆,2369名患者被纳入试验.
- 该研究由国家神经疾病和中风研究所 (2U01NS105565) 资助,并得到了阿尔伯特·爱因斯坦医学院机构审查委员会的批准.
结论:
- 5Cog范式展示了作为初级保健中早期认知障碍检测的有效和实用的工具的潜力.
- 预计这些发现将有助于在各种临床环境中快速采用和传播5Cog范式.
- 该研究的结果将为临床实践和医疗保健政策提供有关老年人认知查的信息.
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