The DOI matches its Crossref record; 58 of the 59 references it cites were found in a registry or an index.
Increasing precision of clinical diagnosis of Alzheimer’s disease using a combined algorithm incorporating clinical and novel biomarker data
Open accessAbstract
Establishing the in vivo diagnosis of Alzheimer’s disease (AD) or other dementias relies on clinical criteria; however, the accuracy of these criteria can be limited. The diagnostic accuracy is 77% for a clinical diagnosis of AD, even among experts. We performed a review through PubMed of articles related to specific diagnostic modalities, including APOE genotyping, cerebrospinal fluid (CSF) testing, fludeoxyglucose F 18 positron emission tomography (PET), amyloid PET, tau PET, computed tomography (CT), single-photon emission CT, magnetic resonance imaging (MRI), and B12 and thyroid-stimulating hormone screening, to determine the specificity and sensitivity of each test used in the clinical diagnosis of AD. We added a novel immunomagnetic reduction assay that provides ultrasensitivity for analyzing the levels of plasma tau and beta amyloid 42 (Aβ 42 ). The sensitivity and specificity of the current diagnostic approach (structural CT or MRI with screening labs) remain low for clinical detection of AD and are primarily used to exclude other conditions. Because of limited diagnostic capabilities, physicians do not feel comfortable or skilled in rendering a clinical diagnosis of AD. Compounding this problem is the fact that inexpensive, minimally invasive diagnostic tests do not yet exist. Biomarkers (obtained through CSF testing or PET imaging), which are not routinely incorporated in clinical practice, correlate well with pathologic changes. While PET is particularly costly and difficult to assess, CSF measures of tau and beta amyloid are not costly, and these tests may be worthwhile when the tiered approach proposed here warrants further testing. There is a need for developing bloodborne biomarkers that can aid in the clinical diagnosis of AD. Here we present a streamlined questionnaire-enriched, biomarker-enriched approach that is more cost-effective than the current diagnosis of exclusion and is designed to increase clinical confidence for a diagnosis of dementia due to AD.
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“In a clinical imaging/pathology series of 57 individuals clinically diagnosed with AD, 13 (23%) had no or sparse beta amyloid (Ab) plaques at autopsy.”
From Concordance of Clinical Alzheimer Diagnosis and Neuropathological Features at Autopsy (2020) · cites this paper as [7]
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“The study concluded that diagnostic accuracy of clinical AD is variable, even among experts (7).”
From Concordance of Clinical Alzheimer Diagnosis and Neuropathological Features at Autopsy (2020) · cites this paper as [7]
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Porsteinsson, A. P., Isaacson, R. S., Knox, S., Sabbagh, M. N., & Rubino, I. (2021) · The Journal of Prevention of Alzheimer's Disease · doi:10.14283/jpad.2021.23 · Cited by 744
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“This is on the grounds that the diagnostic accuracy of human experts reaches 77% [43] with sensitivity and specificity reaching 81% and 70% [5], respectively.”
Background
Metadata
- Authors
- Sabbagh, M. N., Lue, L.-F., Fayard, D., & Shi, J.
- Affiliations
- Barrow Neurological Institute (US)
- Arizona State University (US)
- Corresponding author
- Sabbagh, Marwan N.
- Venue
- Neurology and Therapy
- Published
- 2017-07
- Volume
- 6
- Issue
- S1
- Pages
- 83-95
- ISSN
- 2193-6536 (ISSN-L)
- 2193-8253
- PMC
- PMC5520815
- OpenAlex
- W2737462298
- Cited by
- 107
- References
- 59
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 20 · 2023: 9 · 2022: 11 · 2021: 19 · 2020: 12 · 2019: 6 · 2018: 5 · 2017: 2
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Neurology and Therapy (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Arizona State University Library Digital Repository (Arizona State University) (submittedVersion, cc-by)
- Funders
- Barrow Neurological Foundation (NIA P30 AG019610)
- National Institute on Aging (AG019610, P30AG019610)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Clinical Neurology › Cerebrospinal fluid and hydrocephalus
- Keywords
- Alzheimer's disease, diagnosis, diagnostic accuracy, biomarkers, cerebrospinal fluid, amyloid PET, tau PET, FDG-PET, APOE genotyping, plasma tau, amyloid-beta 42, blood-based biomarkers, dementia, sensitivity and specificity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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