Low-cost Detection of Dementia Using Electronic Health Records Data: Validation and Testing of the eRADAR Algorithm in a Pragmatic, Patient-centered Trial.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,417
- 试验地点
- 10
- 主要终点
- New dementia diagnoses
研究概览
简要总结
The eRADAR Brain Health Study seeks to refine and test a novel, low-cost strategy for increasing dementia detection within primary care.
详细描述
eRADAR stands for "electronic health record (EHR) Risk of Alzheimer's and Dementia Assessment Rule." It is a low-cost tool or algorithm that uses readily available EHR data elements to identify high-risk patients. We will conduct a pragmatic randomized controlled trial to assess the impact of implementing eRADAR as part of a supported outreach process on dementia detection rates. We will also explore the impact of eRADAR implementation on healthcare utilization and patient experience.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Screening
- 盲法
- None
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •No prior diagnosis of dementia (defined from EHR diagnosis codes) and not receiving medications for dementia
- •Active patient at participating clinic
- •Adequate data to calculate eRADAR score
排除标准
- •- Currently receiving hospice care
研究组 & 干预措施
Brain Health Intervention
Participants in the intervention arm were invited to attend a "brain health" visit with a trained research interventionist who was a licensed clinician (e.g., social worker.) They were sent a mailed outreach letter and information sheet, with follow-up phone calls. At the visit, the research interventionist asked about memory symptoms and ability to perform instrumental activities of daily living (IADLs) and screened for cognitive impairment and depression. Results were shared with the participant and their primary care physician (PCP), who was responsible for follow up and more evaluation if needed and for making a final diagnosis of dementia, if applicable.
干预措施: Brain Health Assessment (Other)
Usual care
Individuals in this arm did not receive any intervention but rather usual care. Kaiser Permanente Washington does not routinely screen for cognitive impairment (in line with current guidelines from the US Preventive Services Task Force).
结局指标
主要结局
New dementia diagnoses
时间窗: 12 months after index date
Rate of new dementia diagnoses identified from the electronic health record (EHR) using a prespecified set of ICD-10 codes
New Dementia Diagnoses
时间窗: 12 months after index date
Rate of new dementia diagnoses identified from the electronic health record (EHR) using a prespecified set of ICD-10 codes
次要结局
- Clinic "no shows"(1 year after index date)
- Medication adherence(1 year after index date)
- Dementia medications(6 months after index date)
- Rate of accepting brain health visit(3 months after invitation mailed)
- Urgent care/emergency department visits(1 year after index date)
- Healthcare utilization(6 months after index date)
- New diagnoses of mild cognitive impairment(12 months after index date)
- Hospitalizations(1 year after index date)
- New dementia diagnoses (secondary definitions)(6 months after index date; 18 months after index date)
- Positive predictive value of eRADAR algorithm(12 months after index date)
- Number of Patients Who Received a New Diagnosis of Mild Cognitive Impairment or Dementia(12 months after index date)
- Number of Patients Who Received New Dementia Diagnoses in 18 Months of Follow-up(18 months after index date)
- Number of Patients Who Received a New Dementia Diagnosis in 6 Months of Follow-up(6 months)
- Number of Patients Who Received a New Dementia Medication(12 months after index date)
- Number of Patients With Urgent Care/Emergency Department Visits(1 year after index date)
- Average Number of Hospitalizations(1 year after index date)
- Average Number of "no Shows" for Scheduled Clinic Visits(1 year after index date)
- Average Number of Visits in Primary Care - 6 Months(6 months)
- Average Number of Visits in Primary Care - 12 Months(12 months)
- Number of Patients Who Received a B12 Lab Test(12 months)
- Number of Patients Who Received Neuroimaging(12 months)
- Number of Patients Who Received Neurology Referrals(12 months)