Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
J Am Med Dir Assoc. 2017 Dec 1;18(12):1010-1018.e1. doi: 10.1016/j.jamda.2017.07.014. Epub 2017 Sep 18.
To survey the current methods used to ascertain dementia and mild cognitive impairment (MCI) in longitudinal cohort studies, to categorize differences in approaches and to identify key components of expert panel methodology in current use.
We searched PubMed for the past 10 years, from March 6, 2007 to March 6, 2017 using a combination of controlled vocabulary and keyword terms to identify expert panel consensus methods used to diagnose MCI or dementia in large cohort studies written in English. From these results, we identified a framework for reporting standards and describe as an exemplar the clinical consensus procedure used in an ongoing study of elective surgery patients (the Successful Aging after Elective Surgery study).
Thirty-one articles representing unique cohorts were included. Among published methods, membership of experts panel varied significantly. There was more similarity in what types of information was use to ascertain disease status. However, information describing the diagnostic decision process and resolution of disagreements was often lacking.
Methods used for expert panel diagnosis of MCI and dementia in large cohort studies are widely variable, and there is a need for more standardized reporting of these approaches. By describing the procedure in which our expert panel achieved consensus diagnoses, we hope to encourage the development and publication of well-founded and reproducible methods for diagnosis of MCI and dementia in longitudinal studies.
调查目前在纵向队列研究中确定痴呆和轻度认知障碍(MCI)的方法,对方法的差异进行分类,并确定当前使用的专家小组方法的关键组成部分。
我们使用受控词汇和关键词组合,从 2007 年 3 月 6 日至 2017 年 3 月 6 日在 PubMed 上搜索过去 10 年的文献,以确定用于诊断大型队列研究中 MCI 或痴呆的专家小组共识方法,这些研究均为英文撰写。根据这些结果,我们确定了报告标准的框架,并以正在进行的择期手术患者(成功老龄化后择期手术研究)研究中使用的临床共识程序为例进行了描述。
有 31 篇文章代表了独特的队列,被纳入研究。在已发表的方法中,专家小组的成员差异很大。虽然确定疾病状态所使用的信息类型较为相似,但用于描述诊断决策过程和解决分歧的信息通常缺乏。
在大型队列研究中,用于专家小组诊断 MCI 和痴呆的方法差异很大,因此需要更标准化地报告这些方法。通过描述我们的专家小组达成共识诊断的程序,我们希望鼓励开发和发表用于纵向研究中 MCI 和痴呆诊断的有充分依据和可重复的方法。