Clinicians' views on conversations and shared decision making in diagnostic testing for Alzheimer's disease: The ABIDE project

Alzheimers Dement (N Y). 2017 May 10;3(3):305-313. doi: 10.1016/j.trci.2017.03.009. eCollection 2017 Sep.


Introduction: This study explores clinicians' views on and experiences with when, how, and by whom decisions about diagnostic testing for Alzheimer's disease are made and how test results are discussed with patients.

Methods: Following a preparatory focus group with 13 neurologists and geriatricians, we disseminated an online questionnaire among 200 memory clinic clinicians.

Results: Respondents were 95 neurologists and geriatricians (response rate 47.5%). Clinicians (74%) indicated that decisions about testing are made before the first encounter, yet they favored a shared decision-making approach. Patient involvement seems limited to receiving information. Clinicians with less tolerance for uncertainty preferred a bigger say in decisions (P < .05). Clinicians indicated to always communicate the diagnosis (94%), results of different tests (88%-96%), and risk of developing dementia (66%).

Discussion: Clinicians favor patient involvement in deciding about diagnostic testing, but conversations about decisions and test results can be improved and supported.

Keywords: Alzheimer; Communication; Dementia; Diagnostic testing; Shared decision making.