International consensus on quality indicators for comprehensive assessment of dementia in young adults using a modified e-Delphi approach.

OBJECTIVE To develop guidance for clinicians about essential elements that can support clinical decision-making in the diagnostic workup of young onset dementia. METHODS/DESIGN Three iterations of a modified e-Delphi consensus survey comprising 23 international expert clinicians specialising in diagnosis of young onset dementia. OUTCOME MEASURES A priori consensus was pre-defined as 80% of experts ranking statements in the upper threshold on a seven-point Likert scale that ranged from "not important at all" to "absolutely essential" to diagnosis. RESULTS 80% consensus was reached on 48 statements that were rated as 'absolutely essential' or "very important" to a comprehensive assessment of dementia in a younger adult. In order to inform a subsequent audit of clinical records in which compliance with these statements was assessed, the statements were divided into a Minimum Standard, (consisting of the 15 statements voted by all experts as being "absolutely essential" or "very important") and a Gold Standard where 48 statements were voted by 80% of the experts as being 'absolutely essential' or 'very important'. The expert's response rate across the three rounds was 91.3%. CONCLUSION A minimum standard and gold standard have been created for the diagnostic workup of young onset dementia. The standards provide a clinically useful tool for decision-making particularly for generalists and those with less experience in the field. The standards will be used to inform a UK case note audit of recently diagnosed patients with YOD. This article is protected by copyright. All rights reserved.