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Predicting AD conversion: comparison between prodromal AD guidelines and computer assisted PredictAD tool

Authors

Liu, Yawu, Mattila, Jussi, Ruiz, Miguel Ángel Muñoz, Paajanen, Teemu, Koikkalainen, Juha, van Gils, Mark, Herukka, Sanna-Kaisa, Waldemar, Gunhild, Lötjönen, Jyrki, Soininen, Hilkka

Journal

Plos One, Volume: 8, No.: 2, Pages.: e55246-e55246

Year of Publication

2013

Abstract

Purpose: To compare the accuracies of predicting AD conversion by using a decision support system (PredictAD tool) and current research criteria of prodromal AD as identified by combinations of episodic memory impairment of hippocampal type and visual assessment of medial temporal lobe atrophy (MTA) on MRI and CSF biomarkers.; Methods: Altogether 391 MCI cases (158 AD converters) were selected from the ADNI cohort. All the cases had baseline cognitive tests, MRI and/or CSF levels of Aβ1-42 and Tau. Using baseline data, the status of MCI patients (AD or MCI) three years later was predicted using current diagnostic research guidelines and the PredictAD software tool designed for supporting clinical diagnostics. The data used were 1) clinical criteria for episodic memory loss of the hippocampal type, 2) visual MTA, 3) positive CSF markers, 4) their combinations, and 5) when the PredictAD tool was applied, automatically computed MRI measures were used instead of the visual MTA results. The accuracies of diagnosis were evaluated with the diagnosis made 3 years later.; Results: The PredictAD tool achieved the overall accuracy of 72% (sensitivity 73%, specificity 71%) in predicting the AD diagnosis. The corresponding number for a clinician’s prediction with the assistance of the PredictAD tool was 71% (sensitivity 75%, specificity 68%). Diagnosis with the PredictAD tool was significantly better than diagnosis by biomarkers alone or the combinations of clinical diagnosis of hippocampal pattern for the memory loss and biomarkers (p≤0.037).; Conclusion: With the assistance of PredictAD tool, the clinician can predict AD conversion more accurately than the current diagnostic criteria.;

Bibtex Citation

@article{Liu_2013, doi = {10.1371/journal.pone.0055246}, url = {http://dx.doi.org/10.1371/journal.pone.0055246}, year = 2013, month = {feb}, publisher = {Public Library of Science ({PLoS})}, volume = {8}, number = {2}, pages = {e55246}, author = {Yawu Liu and Jussi Mattila and Miguel {'{A}}ngel Mu{~{n}}oz Ruiz and Teemu Paajanen and Juha Koikkalainen and Mark van Gils and Sanna-Kaisa Herukka and Gunhild Waldemar and Jyrki Lötjönen and Hilkka Soininen}, editor = {Kewei Chen}, title = {Predicting {AD} Conversion: Comparison between Prodromal {AD} Guidelines and Computer Assisted {PredictAD} Tool}, journal = {{PLoS} {ONE}} }

Keywords

aged, alzheimer disease, decision support techniques, diagnosis, diagnostic, female, humans, male, methods, mild cognitive impairment, practice guidelines as topic, prodromal symptoms, sensitivity and specificity, software, support, tool

Countries of Study

Finland

Types of Dementia

Alzheimer’s Disease, Mild Cognitive Impairment (MCI)

Types of Study

Instrument development and testing (cross walking of measures, etc.)

Type of Interventions

Diagnostic Target Identification

Diagnostic Targets

Other