Diagnostic Test Accuracy Studies in Dementia A Pragmatic Approach
This book explains the key steps in planning and executing diagnostic test accuracy studies in dementia, with clear explanations of difficulties and pitfalls, and with jargon clearly explained. The emphasis is on pragmatic diagnostic test accuracy studies
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Diagnostic Test Accuracy Studies in Dementia
A.J. Larner
Diagnostic Test Accuracy Studies in Dementia A Pragmatic Approach
A.J. Larner Cognitive Function Clinic Walton Centre for Neurology and Neurosurgery Liverpool UK
ISBN 978-3-319-16696-4 ISBN 978-3-319-16697-1 DOI 10.1007/978-3-319-16697-1
(eBook)
Library of Congress Control Number: 2015937383 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com)
To Martin Loyal cousin; dedicated healthcare professional
Preface
This book has evolved from more than a decade of personal experience in conducting diagnostic test accuracy studies of clinical signs and cognitive and non-cognitive screening instruments in a dedicated cognitive disorders clinic. Many of these studies have been published, and are summarised elsewhere (Larner 2014a, b). The ageing of the human population with the consequent increase in numbers of individuals afflicted with cognitive impairment and dementia mandates diagnostic test accuracy studies to identify and eventually treat these patients effectively. If, as seems likely, population based testing for early identification becomes the future policy norm, the requirement for tests with established high diagnostic test accuracy is self-evident. A rigorous methodology developed to generate meaningful data from such studies is therefore an imperative need. As well as giving a general overview, the book gives particular emphasis to, and argues in favour of, what I have previously termed “pragmatic diagnostic accuracy studies” (Larner 2012a, 2014a: 33–5). This methodology seems to me to correspond largely with Sackett and Haynes’ (2002) nomenclature of addressing a “Phase III question”, i.e. among patients in whom it is clinically sensible to suspect the target diso
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