Evaluating combinations of diagnostic tests to discriminate different dementia types

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Date
2018
Author
Bruun, Marie
Rhodius-Meester, Hanneke FM
Koikkalainen, Juha
Baroni, Marta
Gjerum, Le
Lemstra, Afina W
Barkhof, Frederik
Remes, Anne M
Urhemaa, Timo
Tolonen, Antti
Rueckert, Daniel
van Gils, Mark
Frederiksen, Kristian S
Waldemar, Gunhild
Scheltens, Philip
Mecocci, Patrizia
Soininen, Hilkka
Lötjönen, Jyrki
Hasselbalch, Steen G
van der Flier, Wiesje M
Unique identifier
10.1016/j.dadm.2018.07.003
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Citation
Bruun, Marie. Rhodius-Meester, Hanneke FM. Koikkalainen, Juha. Baroni, Marta. Gjerum, Le. Lemstra, Afina W. Barkhof, Frederik. Remes, Anne M. Urhemaa, Timo. Tolonen, Antti. Rueckert, Daniel. van Gils, Mark. Frederiksen, Kristian S. Waldemar, Gunhild. Scheltens, Philip. Mecocci, Patrizia. Soininen, Hilkka. Lötjönen, Jyrki. Hasselbalch, Steen G. van der Flier, Wiesje M. (2018). Evaluating combinations of diagnostic tests to discriminate different dementia types.  Alzheimer's & dementia : diagnosis, assessment & disease monitoring, 10, 509-518. 10.1016/j.dadm.2018.07.003.
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CC BY-NC-ND https://creativecommons.org/licenses/by-nc-nd/4.0/
Abstract

Introduction
We studied, using a data-driven approach, how different combinations of diagnostic tests contribute to the differential diagnosis of dementia.

Methods
In this multicenter study, we included 356 patients with Alzheimer's disease, 87 frontotemporal dementia, 61 dementia with Lewy bodies, 38 vascular dementia, and 302 controls. We used a classifier to assess accuracy for individual performance and combinations of cognitive tests, cerebrospinal fluid biomarkers, and automated magnetic resonance imaging features for pairwise differentiation between dementia types.

Results
Cognitive tests had good performance in separating any type of dementia from controls. Cerebrospinal fluid optimally contributed to identifying Alzheimer's disease, whereas magnetic resonance imaging features aided in separating vascular dementia, dementia with Lewy bodies, and frontotemporal dementia. Combining diagnostic tests increased the accuracy, with balanced accuracies ranging from 78% to 97%.

Discussion
Different diagnostic tests have their distinct roles in differential diagnostics of dementias. Our results indicate that combining different diagnostic tests may increase the accuracy further.

Subjects
differential diagnosis   biomarkers   diagnostic test assessment   clinical decision support system   CSF   MRI   Alzheimer's disease   frontotemporal dementia   dementia with Lewy bodies   vascular dementia   
URI
https://erepo.uef.fi/handle/123456789/7064
Link to the original item
http://dx.doi.org/10.1016/j.dadm.2018.07.003
Publisher
Elsevier BV
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