Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC, USA.
Department of Population Health Sciences, Duke University, Durham, NC, USA.
J Alzheimers Dis. 2020;74(2):625-636. doi: 10.3233/JAD-190922.
Amyloid-β PET scans will likely become an integral part of the diagnostic evaluation for Alzheimer's disease if Medicare approves reimbursement for the scans. However, little is known about patients' and their care partners' interpretation of scan results.
This study seeks to understand how accurately patients with mild cognitive impairment (MCI) or dementia and their care partners report results of amyloid-β PET scans and factors related to correct reporting.
A mixed-methods approach was used to analyze survey data from 1,845 patient-care partner dyads and responses to open-ended questions about interpretation of scan results from a sub-sample of 200 dyads.
Eighty-three percent of patients and 85% of care partners correctly reported amyloid-β PET scan results. Patients' higher cognitive function was associated with a small but significant decrease in the predicted probability of not only patients accurately reporting scan results (ME: -0.004, 95% CI: -0.007, -0.000), but also care partners accurately reporting scan results (ME: -0.006, 95% CI: -0.007, -0.001), as well as decreased concordance between patient and care partner reports (ME: -0.004, 95% CI: -0.007, -0.001). Content analysis of open-ended responses found that participants who reported the scan results incorrectly exhibited more confusion about diagnostic terminology than those who correctly reported the scan results.
Overall, patients with MCI or dementia showed high rates of accurate reporting of amyloid-β PET scan results. However, responses to questions about the meaning of the scan results highlight the need for improved provider communication, including providing written explanations and better prognostic information.
如果医疗保险批准对扫描进行报销,那么淀粉样蛋白-β PET 扫描很可能成为阿尔茨海默病诊断评估的一个组成部分。然而,人们对患者及其护理伙伴对扫描结果的解释知之甚少。
本研究旨在了解轻度认知障碍(MCI)或痴呆患者及其护理伙伴对淀粉样蛋白-β PET 扫描结果的报告有多准确,以及与正确报告相关的因素。
采用混合方法分析了来自 1845 对患者-护理伙伴对的调查数据,并对 200 对患者-护理伙伴对的亚样本中关于解释扫描结果的开放性问题的回答进行了分析。
83%的患者和 85%的护理伙伴正确报告了淀粉样蛋白-β PET 扫描结果。患者较高的认知功能与患者准确报告扫描结果的预测概率(ME:-0.004,95%CI:-0.007,-0.000)和护理伙伴准确报告扫描结果(ME:-0.006,95%CI:-0.007,-0.001)都显著降低有关,并且患者和护理伙伴报告的一致性降低(ME:-0.004,95%CI:-0.007,-0.001)。对开放性回答的内容分析发现,报告扫描结果不正确的参与者比正确报告扫描结果的参与者对诊断术语更加困惑。
总体而言,MCI 或痴呆患者对淀粉样蛋白-β PET 扫描结果的报告准确率较高。然而,对扫描结果含义的问题的回答突出表明需要改进提供者沟通,包括提供书面解释和更好的预后信息。