Approaches to diagnosing dementia syndrome in general practice: Determining the value of gestalt judgment, clinical history and tests.

Award Number
Status / Stage
14 September 2015 -
13 March 2021
Duration (calculated)
05 years 05 months
Wellcome Trust
Funding Amount
Contracted Centre
University of Bristol
Contracted Centre Webpage
Principal Investigator
Dr Sam Creavin
PI Contact
WHO Catergories
Development of clinical assessment of cognition and function
Methodologies and approaches for risk reduction research
Disease Type
Dementia (Unspecified)

CPEC Review Info
Reference ID308
ResearcherReside Team


Award Number108804/Z/15/Z
Status / StageCompleted
Start Date20150914
End Date20210313
Duration (calculated) 05 years 05 months
Contracted CentreUniversity of Bristol
Contracted Centre Webpage
Funding Amount£321,248.00


I will investigate whether an evaluation in general practice can have comparable test accuracy to a specialist opinion for diagnosing dementia in symptomatic elderly people. Objective 1: I will systematically review the test accuracy of general practitioners gestalt clinical judgment for the diagnosis of dementia in symptomatic primary care patients and, if indicated, perform a meta-analysis. My hypothesis is that the utility of the gestalt clinical judgment of general practitioners in diagn osing dementia is better than chance but inferior to specialist assessment. Objective 2: I will conduct an empirical, prospective, diagnostic test accuracy (DTA) study comparing GP gut feeling , blood tests, neuroimaging, index collection of cognitive tests suitable for GPs and specialist assessment to a reference consensus expert panel diagnosis. I will identify the most useful components of a diagnostic evaluation in general practice. My hypothesis is that a combination of brief cognitive tests adds diagnostic value to a GP’s gestalt judgment. Objective 3: I will conduct exploratory qualitative research to evaluate the feasibility and acceptability of GP diagnosis of dementia for patients and clinicians, based on the set of tests that I identify as most useful.