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- W2980477005 abstract "Although relevant for diagnosing Alzheimer's disease, amyloid beta (Ab) is not measured for all patients in clinical practice due to economic reasons, availability and invasiveness of measurement. Therefore, we evaluated whether a stepwise approach can identify patients who benefit most from having CSF biomarkers assessed. Data from four diagnostic groups, Alzheimer's disease, frontotemporal dementia, vascular dementia and subjective cognitive decline, were included from the Amsterdam Dementia Cohort and PredictND cohort (N=535, Table 1). Each subject had CSF biomarkers, MRI images and neuropsychology test results (MMSE, RAVLT/CERAD, TMT, animal fluency). MRI images were quantified using the cNeuro® cMRI quantification tool. Disease state index technology was used to classify patients to different diagnostic groups [1]. In addition, the technology enables defining probability of correct class (PCC) for each subject estimating the probability that the suggested diagnosis is correct. A diagnosis is made if PCC>cutoff. Figure 1 shows flow-charts for the stepwise and non-stepwise approaches. When the stepwise approach is applied, only neuropsychology and MRI are used first. A diagnosis could be made in 358 patients (PCC>0.7, Figure 1). For the remaining 177 patients, adding Ab biomarkers was simulated: PCC was recomputed by testing if the patient had positive (median of AD group: 504 pg/ml) or negative (median of SCD group: 959 pg/ml) Ab value. Either of these simulated PCC values reached the cutoff in 130 patients. When we added actual CSF results to these patients, a diagnosis could be made in additional 79 patients. In total, 82 % of patients ((358+79)/535)) were diagnosed with accuracy of 90 % but CSF was measured only in 24 % of patients (130/535). For comparison, when CSF was measured for all patients (535/535), accuracy was 92 % and a diagnosis was made in 75 % of patients (401/535). Figure 2 shows share of patients diagnosed, classification accuracy and share of patients with CSF measured for different PCC cutoffs." @default.
- W2980477005 created "2019-10-25" @default.
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- W2980477005 date "2019-07-01" @default.
- W2980477005 modified "2023-09-28" @default.
- W2980477005 title "O2-02-03: STEPWISE PATIENT SELECTION FOR AMYLOID MEASUREMENTS" @default.
- W2980477005 doi "https://doi.org/10.1016/j.jalz.2019.06.4459" @default.
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