Development of a pragmatic model for cognitive screening after cardiac arrest - the DANish Cognitive Screen for Cardiac Arrest Survivors (DANcSCA)

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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 pragmatic model for cognitive screening after cardiac arrest 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 (1). 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 optimal time for screening is six to eight weeks after discharge from the hospital, with screening results categorised as: 'no concerns,' 'need for further assessment,' and 'need for specialised rehabilitation. A model of the screening, along with recommendations for timing and communication of results, is presented. Conclusion We have successfully developed and reported an easy-to-use digital screening tool and procedure for cognitive deficits following cardiac arrest. This approach can potentially enable systematic screening for all cardiac arrest survivors.

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