Development of the DANish Cognitive Screen for Cardiac Arrest Survivors (DANcSCA).

Abstract

BACKGROUND: Cognitive deficits are prevalent among cardiac arrest survivors, yet there is no consensus on standardised screening methods. Hence, a novel screening tool is needed to assist healthcare professionals in determining the necessity of further assessment or rehabilitation. This paper reports on the development process of a cognitive screening for cardiac arrest survivors and makes recommendations for timing and how to communicate the results. METHODS: Based on an iterative process that included clinical observations and roundtable discussions, we underwent a four-phase development process grounded in the GUIDED guidelines (Duncan E, BMJ Open 10:e033516, 2020). RESULTS: During the first phase, we explored the cognitive after-effects of cardiac arrest, focusing on potentially affected cognitive functions, suitable tests, and cognitive rehabilitation needs. The second phase included developing a pen-and-paper neuropsychological screening battery, which proved too resource-intensive due to its reliance on neuropsychologists. Consequently, in the third phase, we transitioned to a tablet-based screening tool. The fourth phase involved proof of concept, assessing whether we had developed a feasible cognitive screening for cardiac arrest survivors that could be implemented in hospital departments and rehabilitation settings. For this procedure, we determined that the appropriate time for screening is six to eight weeks after hospital discharge, with screening results categorised as: 'no concerns,' 'need for further assessment,' and 'need for specialised rehabilitation. The screening, appropriate timing for its administration, and communication of results are presented. CONCLUSION: We have successfully developed and reported a digital screening for cognitive deficits following cardiac arrest. This approach has the potential to enable systematic screening of all cardiac arrest survivors.