Digital Screening Tool Duo Shows Promise for ADRD Detection in Primary Care: Daily Dose

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On November 12, 2025, we reported on a study published in JAMA Network Open that examined the effect of a combined approach of Quick Dementia Rating System (QDRS) plus Passive Digital Marker (PDM) in improving the annual rate of new documented Alzheimer disease and related dementias (ADRD) diagnoses in primary care practices.

The study

Researchers randomly assigned 9 urban federally qualified health centers serving predominantly low-income, diverse populations to 1 of 3 approaches in the clinic:

• usual care with no routine dementia screening

• use of a PDM alone, or

• combined use of the QDRS plus PDM

The QDRS is a 10-question patient-reported outcome (PRO) tool that takes less than 3 minutes to complete and has 85% accuracy for detecting dementia, with a cutoff score of 1.5 on a 0-30 scale. The PDM uses a machine learning algorithm to analyze existing EHR data for early detection of ADRD, achieving 80% accuracy with a risk threshold of 59%. Both tools were embedded directly into the health system's Epic EHR and triggered clinical decision support alerts when results were positive. The trial was performed between July 2, 2022 and July 1, 2024 and enrolled adults 65 years and older without existing diagnoses of cognitive impairment, dementia, or severe mental illness.

The primary outcome was defined as 12-month cumulative incidence of ADRD diagnoses with a secondary outcome including any ADRD diagnostic workup (eg, laboratory tests, neuropsychological testing, or brain imaging).

The findings

Investigators observed early improvements in skin clearance, with significant differences in validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) response rates as early as week 1 and maintained through week 8. Among children with atopic dermatitis-related comorbidities, 42.3% of those treated with tapinarof cream achieved vIGA-AD response compared with 11.8% receiving vehicle (P < .001). In those without comorbidities, response rates were 49.5% with tapinarof vs 14.8% with vehicle (P < .001).

Improvement in Eczema Area and Severity Index (EASI) scores was observed as early as week 2 and sustained through week 8. In children with comorbidities, 54.5% of those using tapinarof cream achieved improvement vs 21.8% with vehicle (P < .001); in those without comorbidities, 63.1% vs 20.4%, respectively (P < .001).

Patient-reported outcomes also improved early in treatment. Total mean Patient-Oriented Eczema Measure (POEM) and POEM sleep scores showed significant differences by week 1 and were maintained through week 8. For participants with comorbidities, total POEM scores were 6.9 with VTAMA vs 12.0 with vehicle (P < .001), and POEM sleep scores were 0.9 vs 1.4 (P = .003). In those without comorbidities, total POEM scores were 6.7 vs 11.9 (P < .001) and POEM sleep scores 0.6 vs 1.4 (P < .001).

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