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BMC Primary Care
Published in: BMC Primary Care 1/2016

Open Access 01-12-2016 | Study protocol

Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol

Authors: Sam T. Creavin, Sarah J. Cullum, Judy Haworth, Lesley Wye, Antony Bayer, Mark Fish, Sarah Purdy, Yoav Ben-Shlomo

Published in: BMC Primary Care | Issue 1/2016

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Abstract

Background

People with cognitive problems, and their families, report distress and uncertainty whilst undergoing evaluation for dementia and perceive that traditional diagnostic evaluation in secondary care is insufficiently patient centred. The James Lind Alliance has prioritised research to investigate the role of primary care in supporting a more effective diagnostic pathway, and the topic is also of interest to health commissioners. However, there are very few studies that investigate the accuracy of diagnostic tests for dementia in primary care.

Methods

We will conduct a prospective diagnostic test accuracy study to evaluate the accuracy of a range of simple tests for diagnosing all-cause-dementia in symptomatic people aged over 70 years who have consulted with their general practitioner (GP). We will invite eligible people to attend a research clinic where they will undergo a range of index tests that a GP could perform in the surgery and also be assessed by a specialist in memory disorders at the same appointment. Participating GPs will request neuroimaging and blood tests and otherwise manage patients in line with their usual clinical practice. The reference standard will be the consensus judgement of three experts (neurologist, psychiatrist and geriatrician) based on information from the specialist assessment, GP records and investigations, but not including items in the index test battery. The target condition will be all-cause dementia but we will also investigate diagnostic accuracy for sub-types where possible. We will use qualitative interviews with patients and focus groups with clinicians to help us understand the acceptability and feasibility of diagnosing dementia in primary care using the tests that we are investigating.

Discussion

Our results will help clinicians decide on which tests to perform in someone where there is concern about possible dementia and inform commissioning of diagnostic pathways.
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Metadata
Title
Towards improving diagnosis of memory loss in general practice: TIMeLi diagnostic test accuracy study protocol
Authors
Sam T. Creavin
Sarah J. Cullum
Judy Haworth
Lesley Wye
Antony Bayer
Mark Fish
Sarah Purdy
Yoav Ben-Shlomo
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2016
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-016-0475-2

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