Evaluating combinations of diagnostic tests to discriminate different dementia types
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CitationBruun, 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.
We studied, using a data-driven approach, how different combinations of diagnostic tests contribute to the differential diagnosis of dementia.
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.
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%.
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.