![]() The results from this study inform the health economics model (e.g. This report focuses on the results from the clinical study, which is one of the work packages of the ADePT study. The primary objective for the ADePT study was to deliver real-world evidence on practices and the economic case for ICA adoption in memory clinics for the assessment of cognitive impairment associated with dementia, Alzheimer’s Disease (AD), Mild Cognitive Impairment (MCI) and similar diseases, including assessment of preferred business models by comparing the precision of GP referrals against the ICA. The Accelerating Dementias Pathways Technologies (ADePT) Study was initiated in order to address this challenge and develop a real-world evidence basis to support the adoption of ICA as an inexpensive screening tool for the detection of cognitive impairment and improving the efficiency of the dementia care pathway. The value proposition of the ICA is that a more accurate and sensitive tool for diagnosis will streamline the diagnosis of dementia by reducing false positive results from GP referrals and therefore minimising the need for further, expensive and time-consuming assessments. The ICA is self-administered and independent of language ( Khaligh-Razavi et al., 2019, Khaligh-Razavi et al., 2020). The ICA is a 5-minute, self-administered computerised cognitive test based on a rapid categorisation task that employs an Artificial Intelligence model to improve its accuracy in detecting cognitive impairment ( Kalafatis et al., 2021). Emerging research in remote memory clinics has highlighted computerised cognitive tests such as the ICA as a prominent candidate for adoption in clinical practice both during the pandemic and for post-COVID implementation as part of healthcare innovation (Dunne at al. However, the remote use of cognitive assessments has been variable, non-standardised while there has been scant evaluation of the outcome of such a change in clinical practice ( Binng et al. Nationally, memory services adapted to the new environment by moving to remote patient assessments in order to continue meeting service user demand while reducing viral transmission ( Owens at al. The COVID-19 pandemic effectively brought clinical practice in the memory services to a standstill. As a result, the majority of appointments were conducted remotely with the use of pen-and-paper tests that are acceptable for remote use. In light of Covid-19, memory clinics have adapted to the new environment by moving to remote patient assessments in order to continue meeting service user demand while reducing viral transmission. ![]() the diagnostic clinic visit), conducted by a dementia medical specialist, the patient receives the outcome of the assessment (see “Outcomes” within Figure 1 for examples of typical outcomes). At the memory clinic patients usually undergo two appointments the first is typically conducted by a nurse or other non-medical professional and involves administration of a cognitive assessment. Patients who are referred by GP are triaged. A key limitation of existing screening tests is the lack of robust evidence to support them few have been well validated in the populations which they are intended for.įigure 1 demonstrates the dementia diagnostic pathway for patients. As a result many false-positives are identified in referred patients. More detailed tests deployed in secondary-care are expensive and often physically and psychologically intrusive for the patient (e.g. Dementia is difficult to diagnose in a study concerning false positive diagnoses, 60% of GPs misdiagnosed dementia ( Shinagawa, 2016). Existing primary care cognitive assessment tools (GPCOG, Mini-Cog, 6CIT etc.), are crude or time-consuming, screening instruments which can only detect cognitive impairment when it is well established. Currently, General Practitioners (GPs) clinical judgement of cognitive impairment is the basis of referral initiation to specialist services. World-wide, national dementia strategies emphasise the need for improving the diagnostic pathway at the point of primary care towards timely diagnosis.
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