Use of a diagnostic decision support tool in memory clinic daily practice – The DAILY feasibility study

Abstract

AbstractBackgroundTo optimally serve increasing numbers of memory clinic patients through a timely and adequate diagnosis, digital health technologies offer a unique potential. Diagnostic decision support systems (DDSS) can aid clinicians in diagnostics and patient communication, but such tools are not widely used in daily practice. We assessed the feasibility of a DDSS prototype consisting of four modules (Figure 1): (1) web‐based cognitive test tool (cCOG); (2) automated MRI‐quantification (cMRI); (3) AI‐based classifier (cDSI); (4) diagnostic report page, providing an easy‐to‐understand overview of all information for clinicians and patients.MethodWe conducted the DAILY feasibility study in five Dutch memory clinics, including 11 clinicians (internal medicine/geriatricians(n = 5), neurologists(n = 2), residents(n = 3), nurse practitioner(n = 1), mean age 38±7y, 11±6y experience), and 43 patients(7 subjective complaints, 19 mild cognitive impairment, 14 dementia, 3 postponed diagnosis, mean age 73±11y), and their care partners(n = 28, 65±11y). Clinicians received instructions to integrate the tool into routine care. Feasibility, usability, and satisfaction were assessed using questionnaires (clinicians, patients, care partners) and interviews (clinicians).ResultClinicians reported using the tool in 34/43(80%) patients. Their overall satisfaction with the tool was acceptable (median 70(IQR 50‐80), scale 0‐100). Out of the four modules, the diagnostic report was most often used (in 70% of patients) and rated as useful by 89% of clinicians, with 70% indicating it contributed to more efficient patient communication. Patients and care partners evaluated the diagnostic report as understandable and helpful. In the interviews, clinicians were predominantly positive regarding the diagnostic report, indicating that it helped create an overview for themselves and their patients. Widely varying opinions indicated that (time‐efficient) use of the complete tool demands more education and practice to obtain the proficiency level needed to adequately integrate the tool into routine practice.ConclusionThe lasting adoption of digital technologies in healthcare is challenging, and efficient and user‐friendly tools are needed. In this study, clinicians, patients, and care partners valued an automatically‐generated, comprehensible report summarizing individual test results. Implementing such a digital report page could contribute to improved patient communication and, ultimately, better care management. Furthermore, our results identified an educational need regarding the use of digital tools.