| Title: |
Clinical judgement of General Practitioners for the diagnosis of dementia:a diagnostic test accuracy study |
| Authors: |
Creavin, Sam T; Haworth, Judy; Fish, Mark; Cullum, Sarah J; Bayer, Anthony; Purdy, Sarah; Ben-Shlomo, Yoav |
| Source: |
Creavin, S T, Haworth, J, Fish, M, Cullum, S J, Bayer, A, Purdy, S & Ben-Shlomo, Y 2021, 'Clinical judgement of General Practitioners for the diagnosis of dementia : a diagnostic test accuracy study', British Journal of General Practice Open. |
| Publication Year: |
2021 |
| Collection: |
University of Bristol: Bristol Reserach |
| Subject Terms: |
dementia; general practice; sensitivity and specificity; medical history taking; system assessment |
| Description: |
Background: General Practitioners (GPs) often report using clinical judgement to diagnose dementia. Aim: Investigate the accuracy of GPs’ clinical judgement for the diagnosis of dementia. Design and Setting: Diagnostic test accuracy study, recruiting from 21 practices around Bristol. Method: The clinical judgement of the treating GP (index test) was based on the information immediately available at their initial consultation with a person aged over 70 years who had cognitive symptoms. The reference standard was an assessment by a specialist clinician, based on a standardised clinical examination and made according to ICD-10 criteria for dementia. Results: 240 people were recruited, with a median age of 80 years (IQR 75 to 84 years), of whom 126 (53%) were men and 132 (55%) had dementia. The median duration of symptoms was 24 months (IQR 12 to 36 months) and the median ACE-III score was 75 (IQR 65 to 87). GP clinical judgement had sensitivity 56% (95% CI 47% to 65%) and specificity 89% (95% CI 81% to 94%). Positive likelihood ratio was higher in people aged 70-79 years (6.5, 95% CI 2.9 to 15) compared to people aged ≥ 80 years (3.6, 95% CI 1.7 to 7.6), and in women (10.4, 95% CI 3.4 to 31.7) compared to men (3.2, 95% CI 1.7 to 6.2), whereas the negative likelihood ratio was similar in all groups. Conclusion: A GP clinical judgement of dementia is specific, but confirmatory testing is needed to exclude dementia in symptomatic people who GPs judge as not having dementia. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/hdl/https://hdl.handle.net/1983/3b72f975-afec-4ebc-886c-1033db950c6d |
| Availability: |
https://hdl.handle.net/1983/3b72f975-afec-4ebc-886c-1033db950c6d; https://research-information.bris.ac.uk/en/publications/3b72f975-afec-4ebc-886c-1033db950c6d; https://research-information.bris.ac.uk/ws/files/278273492/2021_5_26_main_text_GP_judgement_dementia_BJGPo_one_doc_Accepted.pdf |
| Rights: |
info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.A9BC1973 |
| Database: |
BASE |