Do call it screening: How the conceptualisation of dementia screening is intertwined with its practice

Background While the value of early detection of dementia is largely agreed upon, the value of population‐based screening as a means to early detection is controversial. Due to this controversial status, population‐based screening is not recommended in the majority of national dementia plans. Some c...

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Veröffentlicht in:Alzheimer's & dementia 2020-12, Vol.16, p.n/a
Hauptverfasser: Kapeller, Alexandra, Zeiler, Kristin, Gunnarson, Martin
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creator Kapeller, Alexandra
Zeiler, Kristin
Gunnarson, Martin
description Background While the value of early detection of dementia is largely agreed upon, the value of population‐based screening as a means to early detection is controversial. Due to this controversial status, population‐based screening is not recommended in the majority of national dementia plans. Some current practices, though, resemble screening but are called 'active case‐finding' or 'opportunistic screening'. Labelled them as such could help to avoid the ethical scrutiny of screening criteria. Method Two practices, the Annual Wellness Visit in the USA and the UK hospital 'case‐finding' scheme, are analysed with different conceptualisations of screening and case‐finding from the literature. Result Based on this literature, both practices could be called 'opportunistic screening', which, so we argue, should fulfill the same criteria as population‐based screening. Factors distinguishing the practices are the application of clinical judgement, the way the practice is offered, and whether it targets a predefined population. Conclusion No matter how a practice is conceptualised, conforming to the ethical standards should always be ensured. We propose a distinction between population‐based screening, opportunistic screening, and case‐finding. A distinction between active and passive case‐finding is deemed unhelpful.
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Due to this controversial status, population‐based screening is not recommended in the majority of national dementia plans. Some current practices, though, resemble screening but are called 'active case‐finding' or 'opportunistic screening'. Labelled them as such could help to avoid the ethical scrutiny of screening criteria. Method Two practices, the Annual Wellness Visit in the USA and the UK hospital 'case‐finding' scheme, are analysed with different conceptualisations of screening and case‐finding from the literature. Result Based on this literature, both practices could be called 'opportunistic screening', which, so we argue, should fulfill the same criteria as population‐based screening. Factors distinguishing the practices are the application of clinical judgement, the way the practice is offered, and whether it targets a predefined population. Conclusion No matter how a practice is conceptualised, conforming to the ethical standards should always be ensured. 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Due to this controversial status, population‐based screening is not recommended in the majority of national dementia plans. Some current practices, though, resemble screening but are called 'active case‐finding' or 'opportunistic screening'. Labelled them as such could help to avoid the ethical scrutiny of screening criteria. Method Two practices, the Annual Wellness Visit in the USA and the UK hospital 'case‐finding' scheme, are analysed with different conceptualisations of screening and case‐finding from the literature. Result Based on this literature, both practices could be called 'opportunistic screening', which, so we argue, should fulfill the same criteria as population‐based screening. Factors distinguishing the practices are the application of clinical judgement, the way the practice is offered, and whether it targets a predefined population. Conclusion No matter how a practice is conceptualised, conforming to the ethical standards should always be ensured. 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title Do call it screening: How the conceptualisation of dementia screening is intertwined with its practice
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