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Home › Research › Digital health tools

Development and Validation of eRADAR: A Tool Using EHR Data to Detect Unrecognized Dementia

Barnes DE, Zhou J, Walker RL, Larson EB, Lee SJ, Boscardin WJ, Marcum ZA, Dublin S.. Journal of the American Geriatrics Society, 2019-10-14

This page is alzhub.org's plain-English summary of a published study, not the paper itself. It is generated from the record we hold for this study, sourced and linked below — check the original for the full text and methods.

✓ Peer-reviewed alzhub usefulness score 64 out of 100. Digital health tools

Topic: Health services, long-term care and technology

Objectives Early recognition of dementia would allow patients and their families to receive care earlier in the disease process, potentially improving care management and patient outcomes, yet nearly half of patients with dementia are undiagnosed. Our aim was to develop and validate an electronic health record (EHR)-based tool to help detect patients with unrecognized dementia (EHR Risk of Alzheimer's and Dementia Assessment Rule [eRADAR]). Design Retrospective cohort study. Setting Kaiser Permanente Washington (KPWA), an integrated healthcare delivery system. Participants A total of 16 665 visits among 4330 participants in the Adult Changes in Thought (ACT) study, who undergo a comprehensive process to detect and diagnose dementia every 2 years and have linked KPWA EHR data, divided into development (70%) and validation (30%) samples. Measurements EHR predictors included demographics, medical diagnoses, vital signs, healthcare utilization, and medications within the previous 2 years. Unrecognized dementia was defined as detection in ACT before documentation in the KPWA EHR (ie, lack of dementia or memory loss diagnosis codes or dementia medication fills). Results Overall, 1015 ACT visits resulted in a diagnosis of incident dementia, of which 498 (49%) were unrecognized in the KPWA EHR. The final 31-predictor model included markers of dementia-related symptoms (eg, psychosis diagnoses, antidepressant fills), healthcare utilization pattern (eg, emergency department visits), and dementia risk factors (eg, cerebrovascular disease, diabetes). Discrimination was good in the development (C statistic = .78; 95% confidence interval [CI] = .76-.81) and validation (C statistic = .81; 95% CI = .78-.84) samples, and calibration was good based on plots of predicted vs observed risk. If patients with scores in the top 5% were flagged for additional evaluation, we estimate that 1 in 6 would have dementia. Conclusion The eRADAR tool uses existing EHR data to detect patients with good accuracy who may have unrecognized dementia. J Am Geriatr Soc 68:103-111, 2019.

Key findings

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Study details

How this study scored 64/100
How this study's score is builtJournal tier 7 of 10; Journal's citation record left out, no data; Study design 7 of 12; Strength of evidence 3 of 5; Peer-review validation 10 of 10; How recent 2 of 5; Sample size 3 of 4; Effect reported 0 of 3; Studied in people 3 of 3; Randomised / blinded 0 of 2; Times cited left out, no data; Citations per year left out, no data; Impact for its field and year left out, no data; Cited by studies here left out, no data; Still being cited left out, no data; Senior author's track record left out, no data; Institution's track record left out, no data; Multi-centre collaboration left out, no data; Indexed in PubMed 2 of 2; Free to read 0 of 2. 37 of the 58 points it could be judged on, which is 64 of 100. Total 64 of 100.37 of the 58 points we could judge = 64 of 100

Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 37 of the 58 points we could judge it on, which is 64 out of 100.

ComponentPointsWhy
Journal tier 7 / 10 Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society)
Journal's citation record — / 4 No journal record from OpenAlex — left out of this score
Study design 7 / 12 A cohort study following people over time
Strength of evidence 3 / 5 Rated “moderate” in our summary
Peer-review validation 10 / 10 Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent 2 / 5 2020 — within 10 year(s) of the newest study here
Sample size 3 / 4 4,330 participants
Effect reported 0 / 3 No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people 3 / 3 Studied in people (participant count stated)
Randomised / blinded 0 / 2 No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited — / 7 No citation count (not found in OpenAlex) — left out of this score
Citations per year — / 5 No citation count or no year — left out of this score
Impact for its field and year — / 6 No field-weighted citation impact (OpenAlex has none yet) — left out of this score
Cited by studies here — / 6 Not yet checked against this library's citation graph — left out of this score
Still being cited — / 4 No yearly citation counts — left out of this score
Senior author's track record — / 4 Senior author's record not available — left out of this score
Institution's track record — / 3 No institution listed in OpenAlex — left out of this score
Multi-centre collaboration — / 3 Institutions not listed — left out of this score
Indexed in PubMed 2 / 2 Indexed in PubMed (PMID 31612463)
Free to read 0 / 2 Behind a paywall — scores zero
Points 37 / 58 Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 37 of the 58 points we could judge it on is 64 out of 100.
Total 64 / 100 —

What each of these 20 components measures, and what this score is not →

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Cite this study APA, Vancouver, BibTeX · download .bib or .ris

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.

APA 7th

Barnes, D. E., Zhou, J., Walker, R. L., Larson, E. B., Lee, S. J., Boscardin, W. J., et al. (2020). Development and Validation of eRADAR: A Tool Using EHR Data to Detect Unrecognized Dementia. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.16182

Vancouver

Barnes DE, Zhou J, Walker RL, Larson EB, Lee SJ, Boscardin WJ, et al. Development and Validation of eRADAR: A Tool Using EHR Data to Detect Unrecognized Dementia. Journal of the American Geriatrics Society. 2020. doi:10.1111/jgs.16182. PMID: 31612463.

BibTeX

@article{barnes2020-31612463,
  author  = {Barnes, D. E. and Zhou, J. and Walker, R. L. and Larson, E. B. and Lee, S. J. and Boscardin, W. J. and Marcum, Z. A. and Dublin, S.},
  title   = {{Development and Validation of eRADAR: A Tool Using EHR Data to Detect Unrecognized Dementia}},
  journal = {Journal of the American Geriatrics Society},
  year    = {2020},
  doi     = {10.1111/jgs.16182},
  pmid    = {31612463},
  url     = {https://doi.org/10.1111/jgs.16182}
}

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