开发用于改善路易体痴呆症诊断的评估工具包：在 DIAMOND Lewy 研究中的可行性研究。
Development of assessment toolkits for improving the diagnosis of the Lewy body dementias: feasibility study within the DIAMOND Lewy study.
机构信息
Institute of Neuroscience and Newcastle University Institute for Ageing Newcastle University, Newcastle upon Tyne, UK.
Department of Psychiatry, University of Cambridge, Cambrigde, UK.
出版信息
Int J Geriatr Psychiatry. 2017 Dec;32(12):1280-1304. doi: 10.1002/gps.4609. Epub 2016 Dec 8.
OBJECTIVE
The Lewy body dementias (LBD, dementia with Lewy bodies and Parkinson's disease dementia) are the second most common cause of neurodegenerative dementia but remain under-recognised, with long delays from initial assessment to diagnosis. Whilst validated instruments have been developed for key symptoms, there is no brief instrument for overall diagnostic assessment suitable for routine practice. We here report the development of such assessment toolkits.
METHODS
We developed the LBD assessment toolkits in three stages. First, we conducted a systematic search for brief validated assessments for key symptoms and combined these into draft instruments. Second, we obtained feedback on acceptability and feasibility through two rounds of interviews with our patient and public involvement group. This led to modification of the toolkits. Finally, we piloted the toolkits in a feasibility study in routine dementia and Parkinson's disease services to produce final instruments suitable for routine clinical practice.
RESULTS
Eleven clinicians, working in both dementia/memory assessment and Parkinson's disease/movement disorder services, consented to pilot the assessment toolkits and provide feedback on their feasibility. Clinicians worked in routine health service (not academic) settings and piloted the draft toolkits by integrating them into their regular clinical assessments. Feedback obtained informally, by written comments and through qualitative interviews led to modifications and production of final acceptable versions.
CONCLUSIONS
We were able to address an important need, the under-diagnosis of LBD, by developing toolkits for improving the recognition and diagnosis of the LBD, which were acceptable to clinicians working in routine dementia and Parkinson's disease services. © 2016 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons, Ltd.
目的
路易体痴呆（LBD，路易体痴呆和帕金森病痴呆）是第二常见的神经退行性痴呆病因，但仍未得到充分认识，从初始评估到诊断的时间往往很长。虽然已经开发出了针对主要症状的有效工具，但没有适合常规实践的用于整体诊断评估的简短工具。我们在此报告这些评估工具包的开发情况。
方法
我们分三个阶段开发了 LBD 评估工具包。首先，我们进行了系统搜索，以寻找针对主要症状的简短有效评估，并将这些评估组合成草稿工具。其次，我们通过与我们的患者和公众参与小组进行两轮访谈，获得了对可接受性和可行性的反馈。这导致了工具包的修改。最后，我们在常规痴呆症和帕金森病服务中进行了工具包的试点研究，以产生适合常规临床实践的最终工具。
结果
11 名临床医生，分别从事痴呆症/记忆评估和帕金森病/运动障碍服务，同意试点评估工具包，并就其可行性提供反馈。临床医生在常规卫生服务（非学术）环境中工作，并通过将草稿工具包纳入他们的常规临床评估来试点工具包。通过书面意见和定性访谈获得的非正式反馈导致了修改和最终可接受版本的产生。
结论
我们通过开发用于提高对 LBD 的认识和诊断的工具包，解决了一个重要需求，即 LBD 的诊断不足，这些工具包得到了在常规痴呆症和帕金森病服务中工作的临床医生的认可。© 2016 作者。国际老年精神病学杂志由约翰威利父子公司出版。
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