International consensus on quality indicators for comprehensive assessment of dementia in young adults using a modified e‐Delphi approach

O'Malley, Mary, Parkes, Jacqueline, Stamou, Vasileios, La Fontaine, Jenny, Oyebode, Jan and Carter, Janet (2020) International consensus on quality indicators for comprehensive assessment of dementia in young adults using a modified e‐Delphi approach. International Journal of Geriatric Psychiatry, 35 (11). pp. 1309-1321. ISSN 0885-6230

Preview

Accepted Version Available under License In Copyright. Download (596kB) | Preview

Abstract

Objective To develop guidance for clinicians about essential elements that can support clinical decision‐making in the diagnostic workup of young onset dementia. Methods/Design Three iterations of a modified e‐Delphi consensus survey comprising 23 international expert clinicians specialising in diagnosis of young onset dementia. Outcome measures A priori consensus was pre‐defined as 80% of experts ranking statements in the upper threshold on a seven‐point Likert scale that ranged from “not important at all” to “absolutely essential” to diagnosis. Results 80% consensus was reached on 48 statements that were rated as ‘absolutely essential' or “very important” to a comprehensive assessment of dementia in a younger adult. In order to inform a subsequent audit of clinical records in which compliance with these statements was assessed, the statements were divided into a Minimum Standard, (consisting of the 15 statements voted by all experts as being “absolutely essential” or “very important”) and a Gold Standard where 48 statements were voted by 80% of the experts as being ‘absolutely essential' or ‘very important'. The expert's response rate across the three rounds was 91.3%. Conclusion A minimum standard and gold standard have been created for the diagnostic workup of young onset dementia. The standards provide a clinically useful tool for decision‐making particularly for generalists and those with less experience in the field. The standards will be used to inform a UK case note audit of recently diagnosed patients with YOD.