Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
Amsterdam Neuroscience Neurodegeneration, Amsterdam, The Netherlands.
Alzheimers Res Ther. 2024 Apr 8;16(1):75. doi: 10.1186/s13195-024-01433-8.
Both memory clinic professionals and patients see value in digital tools, yet these hardly find their way to clinical practice. We explored the usability of a digital tool to support the diagnostic work-up in daily memory clinic practice. We evaluated four modules that integrate multi-modal patient data (1.cognitive test; cCOG, and 2. MRI quantification; cMRI) into useful diagnostic information for clinicians (3. cDSI) and understandable and personalized information for patients (4. patient report).
We conducted a mixed-methods study in five Dutch memory clinics. Fourteen clinicians (11 geriatric specialists/residents, two neurologists, one nurse practitioner) were invited to integrate the tool into routine care with 43 new memory clinic patients. We evaluated usability and user experiences through quantitative data from questionnaires (patients, care partners, clinicians), enriched with thematically analyzed qualitative data from interviews (clinicians).
We observed wide variation in tool use among clinicians. Our core findings were that clinicians: 1) were mainly positive about the patient report, since it contributes to patient-centered and personalized communication. This was endorsed by patients and care partners, who indicated that the patient report was useful and understandable and helped them to better understand their diagnosis, 2) considered the tool acceptable in addition to their own clinical competence, 3) indicated that the usefulness of the tool depended on the patient population and purpose of the diagnostic process, 4) addressed facilitators (ease of use, practice makes perfect) and barriers (high workload, lack of experience, data unavailability).
This multicenter usability study revealed a willingness to adopt a digital tool to support the diagnostic process in memory clinics. Clinicians, patients, and care partners appreciated the personalized diagnostic report. More attention to education and training of clinicians is needed to utilize the full functionality of the tool and foster implementation in actual daily practice. These findings provide an important step towards a lasting adoption of digital tools in memory clinic practice.
记忆诊所的专业人员和患者都认为数字工具具有价值，但这些工具在临床实践中几乎没有得到应用。我们探讨了一种数字工具的可用性，以支持日常记忆诊所实践中的诊断工作。我们评估了四个模块，这些模块将多模态患者数据（1.认知测试；cCOG 和 2. MRI 定量；cMRI）整合到对临床医生有用的诊断信息（3. cDSI）和对患者易懂且个性化的信息（4. 患者报告）中。
我们在五家荷兰记忆诊所进行了一项混合方法研究。邀请了 14 名临床医生（11 名老年病专家/住院医师、2 名神经科医生、1 名护士从业者）将该工具整合到常规护理中，并对 43 名新的记忆诊所患者进行了评估。我们通过患者、护理伙伴和临床医生的问卷定量数据评估了可用性和用户体验，并通过临床医生的主题分析定性数据进行了补充。
我们观察到临床医生之间的工具使用存在广泛差异。我们的核心发现是，临床医生：1）主要对患者报告持积极态度，因为它有助于以患者为中心和个性化的沟通。这得到了患者和护理伙伴的认可，他们表示患者报告有用且易懂，并帮助他们更好地理解自己的诊断，2）认为该工具在其自身临床能力之外是可以接受的，3）表示该工具的有用性取决于患者人群和诊断过程的目的，4）提出了促进因素（易用性、熟能生巧）和障碍（工作量大、缺乏经验、数据不可用）。
这项多中心可用性研究表明，愿意采用数字工具来支持记忆诊所的诊断过程。临床医生、患者和护理伙伴都赞赏个性化的诊断报告。需要更多关注临床医生的教育和培训，以充分利用工具的全部功能，并促进其在实际日常实践中的实施。这些发现为数字工具在记忆诊所实践中的持久采用迈出了重要一步。
