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Replacing Dogma With Data

Arch Neurol. 2000;57:170-171.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INCONSISTENCY IN the diagnosis of vascular dementia has been recognized now for some years, but not of the magnitude reported by Erkinjuntti et al¹ and now confirmed by Chui et al.² The degree of inconsistency is not trivial: differences in the rate of diagnosis of vascular dementia among criteria are routinely several-fold in magnitude. Not only have Chui et al² re-emphasized this point, but they have also identified the probable reason. Despite a degree of overall similarity, the criteria themselves differ in particular respects. When tested by using computerized algorithms with yes/no branch points, the differences among the criteria exert a substantial effect on the final diagnosis, perhaps rather more than would have been the case if the criteria had been applied in standard clinical practice.

At first sight, a solution seems simple: the various sets of criteria should be disassembled into their component parts, and these parts should be . . . [Full Text of this Article]

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