Feasibility of an online consensus approach for the diagnosis of cognitive impairment and dementia in rural South Africa
Date
2023-03-04
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Abstract
INTRODUCTION:We describe the development and feasibility of using an online consensus
approach for diagnosing cognitive impairment and dementia in rural South
Africa.
METHODS: Cognitive assessments, clinical evaluations, and informant interviews
from Cognition and Dementia in the Health and Aging in Africa Longitudinal Study
(HAALSI Dementia) were reviewed by an expert panel using a web-based platform to
assign a diagnosis of cognitively normal, mild cognitive impairment (MCI), or dementia.
RESULTS: Six hundred thirty-five participants were assigned a final diagnostic category,
with 298 requiring adjudication conference calls. Overall agreement between
each rater’s independent diagnosis and final diagnosis (via the portal or consensus conference)
was 78.3%. A moderate level of agreement between raters’ individual ratings
and the final diagnostic outcomes was observed (average κ coefficient = 0.50).DISCUSSION: Findings show initial feasibility in using an online consensus approach
for the diagnosis of cognitive impairment and dementia in remote, rural, and lowresource
settings.
Description
Keywords
clinical decision making, consensus, dementia diagnosis, Harmonized Cognitive Assessment Protocol, mild cognitive impairment, population-based research, South Africa