. 2022 Apr 2;19(1):285–295. doi: 10.1002/alz.12630

TABLE 1.

Video‐vignette communication elements included per condition

Condition	Elements in condition
C1: Basic information Based on: Current practice, according to real audio‐taped consultations, recorded in eight memory clinics across The Netherlands ⁶⁵ ^a Views of various experts ^c The specific risk of 70% is based on the predictive model by van Maurik et al., ³ and the use of the tool ADappt ⁶⁶ ^b	Information disclosure occurs in a face‐to‐face spoken interaction. “Summary” of previous finding indicating the patient has MCI, from a fictitious consultation a few weeks prior to the current consultation. Summary includes mention of a 50% risk for developing dementia in patients with MCI. Discussion of using an amyloid‐PET scan (to look at amyloid beta [Aß] in the brain). Discussion that Aß is also known as the “Alzheimer's protein.” Discussion that the presence of Aß in the PET scan indicates a higher risk than 50% for developing dementia. Discussion of the patients’ PET‐scan result: amyloid visible on the scan (Aß+). Discussion that due to the Aß+ finding, the patient's risk for dementia is increased to 70%. ^b Time‐frame of risk is specified as “within several years.” Explicitly stated that patient does not currently have dementia.
C2: Elaborate information Based on: Alzheimer's disease information, its relation to amyloid in the brain, based on recommendations in Grill et al. ⁵ and Albert et al. ²	All elements from the basic condition. + Discussion that amyloid‐positive status is an indication that Alzheimer's disease is present. + Time‐frame is specified as “within 3 years” instead of “within several years.” ^b
C3: Non‐specified risk Based on: Current practice, according to real audio‐taped consultations, recorded in eight memory clinics across The Netherlands ⁶⁵ ^a	All elements from the basic condition. + Increased risk estimate is not specified (70% is not mentioned) ^b
C4: Risk best practice Based on: Risk best‐practice recommendations in current literature ⁷ , ⁸	All elements from the basic condition. + Use of natural frequencies (eg, “Out of 100 people like you, 70…”) + Neutral risk framing (equal focus on both potential outcomes, ie “70% risk for developing dementia, but also 30% chance you will not develop dementia”) + Visualization of the risk (eg, visual aid shown on the computer explaining natural frequencies using icon array)
C5: Visual PET‐scan Based on: Visual PET scan based on recommendations in Grill et al. ⁵ and Lingler et al. ⁶	All elements from the basic condition. + Showing the amyloid PET scan of the patient.
C6: Teach‐back Based on: Recommendations in current literature on the use of the teach‐back ⁹ , ¹⁰ , ¹¹	All elements from the basic condition. + Elements from the elaborate information condition. + Use of teach‐back (the physician asks the patient to summarize the information in his own words at the end of the consultation; ie, “Could you tell me in your own words what I just explained, so I can make sure I explained everything correctly?”)
C7: Emotional support Based on: Views of various experts ^c	All elements from the basic condition. Physician provides space for emotions of the patient (ie, by staying quiet to provide the patient more time to experience the emotions). Physician provides a reflection of the observed emotions (eg, “I can see this is difficult for you”).

^{^a}

The base script was developed based on current practice, by listening to audio recordings of real consultations, recorded in eight different memory clinics across The Netherlands. ⁶⁵

^{^b}

Through the predictive models made by van Maurik et al., in combination with the ADappt tool, a specific risk estimate was made possible. ³ , ⁶⁶ Currently in clinical practice, a specific risk estimate is not used; nor is a specific time‐frame. However, for the present study, it was necessary to include both a specific risk estimate, and a specific time‐frame, since: (1) differences in the information provided would be too great between conditions otherwise, and (2) health‐risk information and best practices on how to explain health risks require a frame of reference to interpret the health risk, that is, a specific risk estimate as well as a time‐frame (3 years).

^{^c}

Experts through experience (ie, MCI patients and care partners of patients with MCI and dementia); experts in the field of video‐vignette design or communication research; experts through knowledge (ie, neurologists, colleagues in the field of dementia, and [medical‐] communication experts).