Evidence map›Paper›PMID 41225324›Full record

Trial reportBMC primary care2025

Exposure to clinical decision support and training increases primary care clinician confidence in managing cognitive impairment care but not confidence to diagnose.

Meghan M JaKa, Rebecca C Rossom, Bethany Crouse, A Lauren Crain, Sally K Gustafson, Heidi L Ekstrom, Laura J Zibley, Soo Borson, Patrick J O'Connor, Ann M Werner and 3 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05723523 (A Technology-Driven Intervention to Improve Early Detection and Management of Cognitive Impairment), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05723523 nacompletednot on this map

A Technology-Driven Intervention to Improve Early Detection and Management of Cognitive Impairment

TypeinterventionalSponsorHealthPartners InstituteRan2023 to 2025Enrolled3,230ConditionsDementia, Cognitive ImpairmentArmsCI-CDS
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Meghan M JaKaCenter for Evaluation & Survey Research, HealthPartners Institute, 8170 33rd Ave S, Bloomington, MN 55425, USA. Meghan.M.JaKa@HealthPartners.com.
Rebecca C RossomHealthPartners Institute, Bloomington, 8170 33rd Ave S, Bloomington, 55425, USA.
Bethany CrouseHealthPartners Institute, Bloomington, 8170 33rd Ave S, Bloomington, 55425, USA.
A Lauren CrainHealthPartners Institute, Bloomington, 8170 33rd Ave S, Bloomington, 55425, USA.
Sally K GustafsonHealthPartners Institute, Bloomington, 8170 33rd Ave S, Bloomington, 55425, USA.
Heidi L EkstromHealthPartners Institute, Bloomington, 8170 33rd Ave S, Bloomington, 55425, USA.
Laura J ZibleyCenter for Evaluation & Survey Research, HealthPartners Institute, 8170 33rd Ave S, Bloomington, MN 55425, USA.
Soo BorsonDepartment of Family Medicine, Keck USC School of Medicine, 1975 Zonal Ave, Los Angeles, 90033, USA.
Patrick J O'ConnorHealthPartners Institute, Bloomington, 8170 33rd Ave S, Bloomington, 55425, USA.
Ann M WernerHealthPartners Institute, Bloomington, 8170 33rd Ave S, Bloomington, 55425, USA.
Deepa AppanaHealthPartners Institute, Bloomington, 8170 33rd Ave S, Bloomington, 55425, USA.
Thomas L von SternbergHealthPartners, 8170 33rd Ave S, Bloomington, MN, 55425, USA.
Leah R HansonHealthPartners Institute, Bloomington, 8170 33rd Ave S, Bloomington, 55425, USA.

Funding

A Technology-Driven Intervention to Improve Early Detection and Management of Cognitive ImpairmentR33AG069770 · NIA · HEALTHPARTNERS INSTITUTE · PI HANSON, LEAH R, ROSSOM, REBECCA CLARE · 2022 to 2024
$4.0M
National Institute on Aging of the National Institutes of Health R33AG069770NIA NIH HHS R33 AG069770
6 · The paper itself

Abstract

backgroundCognitive impairment (CI) is projected to significantly increase as the population ages. While primary care clinicians are often the first point of contact for patients with cognitive decline, many clinicians report significant barriers to addressing CI in primary care, including lack of time, lack of established workflow, and low confidence in diagnosing and managing CI.

methodsTo address these barriers, a CI clinician decision support system (CI-CDSS) was developed and is being tested in a cluster randomized, controlled clinical trial in 38 primary care clinics. A secondary aim of the study was to assess whether the CI-CDSS increased clinician confidence in CI diagnosis and management, as measured by surveys administered before and 8-months after CI-CDSS implementation. Primary outcome results of CI diagnosis are awaiting the end of the follow-up period; however, clinician surveys are complete and reported here. The odds ratio (OR) for the interaction between survey time and study arm, estimated in a generalized linear mixed model, tested the significance of change in clinician confidence across study arms. The average marginal effect (AME), estimated in a generalized estimating equation, provided a treatment effect estimate.

resultsWhile self-reported use of the CI-CDSS was modest (32% remembered the tool and 65% of those used it), those who used it reported high satisfaction (97% said the tool helped provide better CI care). Clinicians in CI-CDSS clinics reported increased confidence in managing CI care relative to usual care (UC) clinicians (AME = 16.8, OR = 2.24 [1.05, 4.80]). Trending, but not significant, increases in clinician confidence in diagnosing CI were observed in CI-CDSS clinics when compared to usual care (e.g., distinguishing types of dementia AME = 9.8, OR = 2.08[0.84, 5.14]).

conclusionsThe results of this study demonstrate the potential value of a CI-CDSS in promoting primary care clinician confidence in caring for and diagnosing patients with CI.

trial registrationThis trial is registered on clinicaltrials.gov, NCT05723523 on 02/02/2023.

Indexed as

Clinical CompetenceCognitive DysfunctionDecision Support Systems, ClinicalPhysicians, Primary CareFemaleHumansMalePrimary Health CareClinical decision supportCognitive impairmentDementiaHealthy agingPrimary careScreening, detection, and diagnosis

Identifiers

PMID41225324
PMCPMC12613876

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.