一组疑似痴呆门诊患者的神经病理学诊断结果
Neuropathologic diagnostic outcomes from a cohort of outpatients with suspected dementia.
作者信息
Larson E B, Edwards J K, O'Meara E, Nochlin D, Sumi S M
机构信息
Department of Medicine, University of Washington School of Medicine, USA.
出版信息
J Gerontol A Biol Sci Med Sci. 1996 Nov;51(6):M313-8. doi: 10.1093/gerona/51a.6.m313.
BACKGROUND
Researchers, clinicians, patients, and families need to know the accuracy of clinical dementia diagnoses.
METHODS
A prospective cohort of outpatients presenting with complaints of cognitive impairment to a geriatric clinic was established from 1978 to 1982. All patients initially received a standardized clinical evaluation and then were followed longitudinally.
RESULTS
Of 304 patients originally enrolled, 72 have come to autopsy and neuropathologic evaluation. Of those patients, 56 had been clinically diagnosed with Alzheimer's disease (AD) and 16 had been diagnosed with other conditions. The sensitivity, specificity, and diagnostic accuracy of the clinical diagnosis of AD compared with neuropathologic diagnosis was 95%, 81%, and 92%, respectively.
CONCLUSION
Our findings support the conclusion that the practicing clinician using standardized clinical criteria can accurately diagnose AD approximately 90% of the time. These data may also be useful in the planning of future care of the AD patient.
背景
研究人员、临床医生、患者及其家属需要了解临床痴呆诊断的准确性。
方法
1978年至1982年建立了一个前瞻性队列，纳入向老年病诊所主诉认知障碍的门诊患者。所有患者最初均接受标准化临床评估，然后进行纵向随访。
结果
最初纳入的304例患者中，72例已进行尸检和神经病理学评估。在这些患者中，56例临床诊断为阿尔茨海默病（AD），16例诊断为其他疾病。与神经病理学诊断相比，AD临床诊断的敏感性、特异性和诊断准确性分别为95%、81%和92%。
结论
我们的研究结果支持以下结论：使用标准化临床标准的执业临床医生大约90%的时间能够准确诊断AD。这些数据也可能有助于AD患者未来护理的规划。
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