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当代阿耳茨海默病研究

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ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

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Research Article

临床决策支持工具对记忆诊所痴呆诊断的影响：PredictND验证研究

卷 16, 期 2, 2019

页: [91 - 101] 页: 11

弟呕挨: 10.2174/1567205016666190103152425

摘要

背景：确定痴呆的潜在病因可能具有挑战性。基于计算机的临床决策支持系统（CDSS）有可能提供客观的数据比较并协助临床医生。 目的：评估CDSS（PredictND工具）对记忆诊所痴呆的鉴别诊断的诊断影响。 方法：在这项前瞻性多中心研究中，我们招募了779名患者，其主观认知能力下降（n = 252），轻度认知障碍（n = 219）或任何类型的痴呆（n = 274），并且随访至少12个月。基于所有可用的患者基线数据（人口统计学，神经心理学测试，脑脊髓液生物标志物和MRI视觉和计算评级），PredictND工具提供数据的全面概述和分析，具有五个诊断组的似然指数;阿尔茨海默病，血管性痴呆，路易体痴呆，额颞叶痴呆和主观认知能力下降。在基线时，临床医生定义了病因诊断和诊断信心，首先是没有，然后使用PredictND工具。后续诊断用作参考诊断。 结果：总共有747名患者完成了随访（53％为女性，69±10岁）。使用PredictND工具时，病例诊断在所有病例中有13％发生变化，但诊断准确性没有显着变化。通过视觉模拟评分（VAS，0-100％）测量的诊断信心增加（ΔVAS= 3.0％，p <0.0001），特别是在正确改变的诊断中（ΔVAS= 7.2％，p = 0.0011）。 结论：将PredictND工具添加到诊断评估中会影响诊断并提高临床医生对诊断的信心，表明CDSS可以帮助临床医生对痴呆进行鉴别诊断。

关键词: 计算机辅助诊断，神经退行性疾病，CDSS，鉴别诊断，阿尔茨海默病，额颞部疾病，路易体痴呆，血管性痴呆。

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