Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
Towards a new Value-based scenario for the management of dementia in Italy: a SINdem delphi consensus study.
СтатьяConsensus StatementНазвание и аннотация: Перевод пока не подготовлен
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Marra Camillo, Beccia Flavia, Caffarra Paolo, L'Abbate Federica, Agosta Federica, Benussi Alberto, Bonanni Laura, Bruni Amalia C, Bruno Giuseppe, Cappa Stefano F, Cerami Chiara, Di Lorenzo Francesco, Ferrarese Carlo, Galimberti Daniela, Guarnieri Biancamaria, Mariani Claudio, Nacmias Benedetta, Pantoni Leonardo, Piccoli Tommaso, Perani Daniela, Rainero Innocenzo, Tagliavini Fabrizio, Venneri Annalena, Boccia Stefania, Cagnin Annachiara, Calabrò Giovanna Elisa, Bozzali Marco, SINdem DELPHI Consensus Group
Аннотация
UNLABELLED: This national expert-based Delphi-consensus aims at formulating recommendations on the management of dementia care in Italy. This effort seems important and timely given in light of a new scenario arising from a new biological definition of Alzheimer's disease (AD) and the availability of disease-modifying treatments (DMTs).
METHODS: the Steering Committee of the Italian Neurological Society for dementia (SINdem) created appropriate statements. Invited SINdem experts were requested to vote on the statements according to a modified three-round Delphi method. Only those statements reaching Grade A (full agreement ≥ 75%) or B (overall agreement ≥ 80% and full disagreement < 5%) were included in the final document. Round answers' consistency was graded using the Cohen's k and within-class correlation coefficient.
RESULTS: Forty-six experts voted on 20 statements, which focused on the following aspects: i) organization of care services from early diagnosis to the management of advanced clinical stages; ii) access to biomarkers for a biological diagnosis of AD; iii) requirements necessary for the administration of DMTs; iv) main actors and pathways for the management of patients suffering from cognitive disorders. At the end of the process, 4 statements (20%) received a Grade A consensus, while 16 (80%) reached a Grade B consensus. Although the responses reflect heterogeneity among Italian regions, there was a fair degree of consistency for all statements.
CONCLUSION: The high strength of this expert-based Delphi-consensus may offer guidance for improving the patient's journey of individuals with cognitive decline from a biological diagnosis to DMTs administration and may possibly offer hints to the Health Systems on dementia.
METHODS: the Steering Committee of the Italian Neurological Society for dementia (SINdem) created appropriate statements. Invited SINdem experts were requested to vote on the statements according to a modified three-round Delphi method. Only those statements reaching Grade A (full agreement ≥ 75%) or B (overall agreement ≥ 80% and full disagreement < 5%) were included in the final document. Round answers' consistency was graded using the Cohen's k and within-class correlation coefficient.
RESULTS: Forty-six experts voted on 20 statements, which focused on the following aspects: i) organization of care services from early diagnosis to the management of advanced clinical stages; ii) access to biomarkers for a biological diagnosis of AD; iii) requirements necessary for the administration of DMTs; iv) main actors and pathways for the management of patients suffering from cognitive disorders. At the end of the process, 4 statements (20%) received a Grade A consensus, while 16 (80%) reached a Grade B consensus. Although the responses reflect heterogeneity among Italian regions, there was a fair degree of consistency for all statements.
CONCLUSION: The high strength of this expert-based Delphi-consensus may offer guidance for improving the patient's journey of individuals with cognitive decline from a biological diagnosis to DMTs administration and may possibly offer hints to the Health Systems on dementia.