Editorial |

Criteria for Vascular Dementia:  Replacing Dogma With Data

John V. Bowler, MB, MD, MRCP; Vladimir Hachinski, MD, FRPC, DSc
Arch Neurol. 2000;57(2):170-171. doi:10.1001/archneur.57.2.170.
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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.

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