Reliability In Neurocognitive Telemedicine Screening (RING)
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 300
- 试验地点
- 1
- 主要终点
- Concordance between telephone-administered modified Mini-Cog and standard in-person Mini-Cog assessment
研究概览
简要总结
Perioperative neurocognitive disorders are common after surgery and pre-existing cognitive impairment is an important risk factor. Current guidelines recommend identifying cognitive impairment before surgery; however, screening remains inconsistent, particularly when preoperative assessments are performed remotely.
This prospective observational diagnostic validation study aims to determine whether a modified Mini-Cog cognitive screening tool administered by telephone can reliably identify cognitive impairment in patients aged 65 years and older undergoing preoperative assessment. Telephone-based modified Mini-Cog results will be compared with standard in-person Mini-Cog assessments to evaluate agreement and feasibility. This study may improve access to preoperative cognitive screening and support optimization of surgical care for older adults.
详细描述
Perioperative neurocognitive disorders (PND) are common and associated with significant morbidity and economic costs. One of the dominant risk factors for PND is pre-existing cognitive impairment (CI). The importance of detecting CI pre-operatively to facilitate patient selection for optimisation pathways and informed risk assessments is stressed in recent joint guidelines by the American College of Surgeons and the American Geriatrics Society.
Despite these recommendations, screening for pre-operative CI is inconsistently performed. One systematic barrier to CI screening is telemedicine, the use of which has recently seen an inflection point partly precipitated by the Coronavirus pandemic. Telemedicine enables the delivery of tertiary level patient-centred care over expanding geographical catchments, and is likely here to stay.
To date, no brief CI screening tool has been validated for perioperative use via telemedicine.
The Mini-Cog is a brief CI screening tool that is uniquely familiar to perioperative healthcare providers. It is validated in preoperative patients and performs favourably compared to other screening tools in the detection of CI. A Mini-Cog result consistent with CI is strongly associated with postoperative delirium, and is widely used as a trigger for geriatric optimization referral.
Validation of the Mini-Cog delivered via telemedicine is an important step towards improving patient access to CI screening.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Prospective
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with age >65 at time of listing for pre-operative assessment.
- •Patients with a conversational understanding of English language.
- •Patients scheduled for in-person consult with an anaesthesiologist.
- •Patients awaiting surgery at Vancouver General Hospital or University of British Columbia Hospital.
排除标准
- •1. Patients with known cognitive impairment.
结局指标
主要结局
Concordance between telephone-administered modified Mini-Cog and standard in-person Mini-Cog assessment
时间窗: Within 1-2 weeks of telephone assessment
Agreement between modified Mini-Cog scores obtained by telephone and standard in-person Mini-Cog scores in identifying cognitive impairment using the established Mini-Cog cutoff score.
次要结局
- Sensitivity and specificity of telephone modified Mini-Cog(Within 1-2 weeks of telephone assessment)
- Completion time of modified Mini-Cog assessment(During each assessment)
- Feasibility of telephone-based cognitive screening(During telephone assessment)
研究者
Donald J Young, MD, FRCPC
Principal Investigator
University of British Columbia