Karneboge Jonas, von Boehn Ferdinand, Haberstroh Julia
Department of Psychology University of Siegen Siegen Germany.
Alzheimers Dement (Amst). 2025 May 11;17(2):e70112. doi: 10.1002/dad2.70112. eCollection 2025 Apr-Jun.
Assessing capacity to consent to treatment and participation in clinical research with monoclonal anti-beta-amyloid antibodies is critical, especially given the frequent uncertainty in the eligible population. Capacity tends to be underestimated in Alzheimer's patients and overestimated in those with mild cognitive impairment (MCI).
Using the Delphi method, an international expert panel ( = 21) was surveyed in two waves.
The participants reached consensus on 85 % of identified features, 90 % of benefits, and 88 % of risks.
The resulting standard emphasizes the understanding subscale of the MacArthur competence assessment tools (MacCAT) for both treatment and research, supporting use across clinical and research settings. Despite proven utility, only 4 % of psychiatrists currently use tools like MacArthur Competence Assessment Tool for Treatment (MacCAT-T). This consensus aims to promote wider adoption of capacity assessments, integrating them routinely into clinical practice to balance patient autonomy with beneficence.
评估使用单克隆抗β-淀粉样蛋白抗体进行治疗及参与临床研究的同意能力至关重要，尤其是考虑到 eligible population 中常常存在的不确定性。阿尔茨海默病患者的能力往往被低估，而轻度认知障碍（MCI）患者的能力则往往被高估。
采用德尔菲法，分两波对一个国际专家小组（n = 21）进行了调查。
参与者在85%的已识别特征、90%的益处和88%的风险方面达成了共识。
由此产生的标准强调了麦克阿瑟能力评估工具（MacCAT）中针对治疗和研究的理解子量表，支持在临床和研究环境中使用。尽管已证明其效用，但目前只有4%的精神科医生使用诸如麦克阿瑟治疗能力评估工具（MacCAT-T）之类的工具。这一共识旨在促进能力评估的更广泛采用，将其常规纳入临床实践，以平衡患者自主权与行善原则。
