Dataset Information

Accuracy of general hospital dementia diagnoses in England: Sensitivity, specificity, and predictors of diagnostic accuracy 2008-2016.

ABSTRACT:

Introduction

Recognizing dementia in general hospitals allows for tailored care. We aimed to assess hospital dementia diagnosis accuracy, changes over time, and predictors of correct identification.

Method

Retrospective cohort study of people over 65 years, using data from a large mental health care database as gold standard, linked to 2008-2016 English hospital data.

Results

In 21,387 people who had 138,455 admissions, we found sensitivity and specificity of dementia recording, respectively, to be 78.0% and 92.0% for each person's complete records, and 63.3% and 96.6% for each nonelective admission. Diagnostic sensitivity increased between 2008 and 16. Accurate general hospital recording of the presence of dementia was lower in ethnic minority groups, younger, single people, and those with physical illness.

Discussion

Dementia diagnosis recording in general hospitals is increasing but remains less likely in some groups. Clinicians should be aware of this inequity and have a higher index of clinical suspicion in these groups.

SUBMITTER: Sommerlad A

PROVIDER: S-EPMC6057268 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Publications

Accuracy of general hospital dementia diagnoses in England: Sensitivity, specificity, and predictors of diagnostic accuracy 2008-2016.

Sommerlad Andrew A Perera Gayan G Singh-Manoux Archana A Lewis Glyn G Stewart Robert R Livingston Gill G

Alzheimer's & dementia : the journal of the Alzheimer's Association 20180425 7

<h4>Introduction</h4>Recognizing dementia in general hospitals allows for tailored care. We aimed to assess hospital dementia diagnosis accuracy, changes over time, and predictors of correct identification.<h4>Method</h4>Retrospective cohort study of people over 65 years, using data from a large mental health care database as gold standard, linked to 2008-2016 English hospital data.<h4>Results</h4>In 21,387 people who had 138,455 admissions, we found sensitivity and specificity of dementia recor ...[more]

PMID: 29703698

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Project description:BackgroundIntimate partner violence (IPV) including physical, sexual and emotional violence, causes short and long term ill-health. Brief questions that reliably identify women experiencing IPV who present in clinical settings are a pre-requisite for an appropriate response from health services to this substantial public health problem. We estimated the sensitivity and specificity of four questions (HARK) developed from the Abuse Assessment screen, compared to a 30-item abuse questionnaire, the Composite Abuse Scale (CAS).MethodsWe administered the four HARK questions and the CAS to women approached by two researchers in general practice waiting rooms in Newham, east London. Inclusions: women aged more than 17 years waiting to see a doctor or nurse, who had been in an intimate relationship in the last year.Exclusionswomen who were accompanied by children over four years of age or another adult, too unwell to complete the questionnaires, unable to understand English or unable to give informed consent.ResultsTwo hundred and thirty two women were recruited. The response rate was 54%. The prevalence of current intimate partner violence, within the last 12 months, using the CAS cut off score of >or=3, was 23% (95% C.I. 17% to 28%) with pre-test odds of 0.3 (95% C.I. 0.2 to 0.4). The receiver operator characteristic curve demonstrated that a HARK cut off score of >or=1 maximises the true positives whilst minimising the false positives. The sensitivity of the optimal HARK cut-off score of >or=1 was 81% (95% C.I. 69% to 90%), specificity 95% (95% C.I. 91% to 98%), positive predictive value 83% (95% C.I. 70% to 91%), negative predictive value 94% (95% C.I. 90% to 97%), likelihood ratio 16 (95% C.I. 8 to 31) and post-test odds 5.ConclusionThe four HARK questions accurately identify women experiencing IPV in the past year and may help women disclose abuse in general practice. The HARK questions could be incorporated into the electronic medical record in primary care to prompt clinicians to ask about recent partner violence and to encourage disclosure by patients. Future research should test the effectiveness of HARK in clinical consultations.

Dataset Information

Accuracy of general hospital dementia diagnoses in England: Sensitivity, specificity, and predictors of diagnostic accuracy 2008-2016.

Introduction

Method

Results

Discussion

Publications

Accuracy of general hospital dementia diagnoses in England: Sensitivity, specificity, and predictors of diagnostic accuracy 2008-2016.

Similar Datasets

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