Which ED patients (diagnosed vs undiagnosed, by age group) should be screened for cognitive impairment? (mild cognitive impairment, dementia)? Are there differences by race and ethnicity? How can the ED best identify cognitive impairment? (Best in terms of sensitivity, reliability, practicality, ease and speed of completion, etc) Are there differences by race or ethnicity? Are there pragmatic cognitive impairment screening tools that can identify patients at risk of dementia? (Pragmatic in terms of ease of use, training, quickness to complete, etc) Can educational programmes improve detection of dementia in ED patients? Who in the ED should complete cognitive impairment screenings or assessments? (ED clinicians (physicians, nurses, etc), non-clinicians (technicians, research assistants, etc), patients completing self-assessments on interactive tables, etc) Is there an objective bedside diagnostic test in the ED (ie, plasma test, bedside EEG (electroencephalogram), etc) to improve dementia screening accuracy? (eg, plasma test) When in the ED care continuum should cognitive screening be done? (before, during, after the ED visit) Can the ED screen for undiagnosed dementia and refer patients for further assessment? Are there differences by race and ethnicity? How to account for language and cultural differences with diverse ED population in existing screening tools for cognitive impairment? Is the electronic health record optimised to alert healthcare providers of patients already diagnosed with dementia? Does identification of patients with dementia change ED outcomes for these patients? What outcomes are associated with undiagnosed dementia in the ED? What outcomes are associated with undetected dementia in the ED? What is the impact (positive/negative) of ED dementia screening? In cases of known dementia, does detection include assessment for patient and caregiver support? What are the ethical responsibilities of the ED clinicians to convey information about screening results versus diagnoses? What are the repercussions about reporting dementia detected in the ED and their impact on subsequent care, patient stigma or anxiety? How do symptoms of cognitive impairment without a diagnosis affect persons with dementia, particularly since diagnostic uncertainty frequently occurs in emergency medicine?
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Question 1: How can the ED best identify cognitive impairment? (Best in terms of sensitivity, specificity, reliability, practicality, easy and speed of completion, etc) Are there differences by race or ethnicity?
Question 2: Are there pragmatic cognitive impairment screening tools that can identify patients at risk of dementia? (Pragmatic in terms of ease of use, training, quickness to complete, etc) |
