Supplementary Material for: Deciphering Perspectives: A European survey on clinical decision support tools for dementia and Alzheimer's disease

Introduction: Technological advancements like digital monitoring tools, disease modifying therapies and artificial intelligence have been shown to improve the clinical management of neurocognitive diseases like Alzheimer’s disease (AD). To enhance implementation in daily practice, users’ input is essential in the technology development process. This study aimed to determine clinician's perspective of clinical decision support systems (CDSS) in the management of dementia and AD.
Method: A survey was conducted targeting clinicians practicing in the field of dementia across Europe. A sixty-five-item digital questionnaire was administered, and opinions were enquired across the domains of diagnosis, disease modifying therapy and prognosis, including factors that affect tool implementation and utilization.
Results: Eighty-four clinicians (including specialist physicians, psychologists and nurses) responded to this survey, and more than 50% had no knowledge or experience with CDSS. Most of the respondents reported the ability to predict the likelihood of AD as the most important diagnostic function. It was surprising to find the middling responses for the ability to predict amyloid positivity. The majority indicated assessment of treatment eligibility for disease-modifying therapy as vital, and the ability to predict cognitive and functional decline as the most important prognostic functions. Data accuracy and ease of use were noted as most necessary to facilitate CDSS adoption and implementation.
Conclusion: Findings from this study contribute to the future development of CDSS in this field, especially regarding the approval and imminent use of disease modifying therapies, a comprehensive tool that is precise and user friendly would improve clinical decisions and efficiency.

引言：诸如数字监测工具、疾病修正治疗（disease modifying therapies）与人工智能等技术进步，已被证实可改善阿尔茨海默病（Alzheimer’s disease, AD）等神经认知疾病的临床管理。为提升此类技术在临床日常实践中的落地应用，在技术研发过程中纳入使用者的反馈至关重要。本研究旨在探究临床医师对于临床决策支持系统（clinical decision support systems, CDSS）在痴呆与阿尔茨海默病管理中的应用视角。
方法：本研究针对欧洲范围内从事痴呆领域临床工作的医师开展了一项调查。研究采用了一份包含65个条目的数字化问卷，调研内容覆盖诊断、疾病修正治疗与预后三大领域，同时涵盖影响工具落地与使用的相关因素。
结果：共有84名临床医师（包括专科医师、心理师与护理人员）参与了本次调查，其中超过50%的受访者对临床决策支持系统毫无了解或使用经验。多数受访者认为，预测阿尔茨海默病发病风险的能力是该系统最重要的诊断功能。值得注意的是，针对预测淀粉样蛋白阳性的相关问题，受访者的反馈整体处于中等水平。绝大多数受访者表示，评估疾病修正治疗的治疗适配性是至关重要的功能，而预测认知与功能衰退的能力则是最核心的预后功能。研究指出，数据准确性与易用性是推动临床决策支持系统落地与普及的核心必要条件。
结论：本研究结果可为该领域临床决策支持系统的后续研发提供参考，尤其是在疾病修正治疗获批并即将投入临床使用的背景下。一款精准易用的综合性工具，将有助于优化临床决策并提升诊疗效率。