A blood biomarker test for brain amyloid impacts the clinical evaluation of cognitive impairment

The objective of this study was to examine clinicians' patient selection and result interpretation of a clinically validated mass spectrometry test measuring amyloid beta and ApoE blood biomarkers combined with patient age (PrecivityAD® blood test) in symptomatic patients evaluated for Alzheime...

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Bibliographic Details
Published in:Annals of clinical and translational neurology 2023-10, Vol.10 (10), p.1738-1748
Main Authors: Monane, Mark, Johnson, Kim G, Snider, B Joy, Turner, Raymond S, Drake, Jonathan D, Maraganore, Demetrius M, Bicksel, James L, Jacobs, Daniel H, Ortega, Julia L, Henderson, Joni, Jiang, Yan, Huang, Shuguang, Coppinger, Justine, Fogelman, Ilana, West, Tim, Braunstein, Joel B
Format: Article
Language:English
Subjects:
Accuracy
Age
Alzheimer's disease
Biomarkers
Blood tests
Cognitive ability
Dementia
Mass spectrometry
Medical laboratories
Patients
Plasma
Quality improvement
Regression analysis
Scientific imaging
Test methods
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Summary:The objective of this study was to examine clinicians' patient selection and result interpretation of a clinically validated mass spectrometry test measuring amyloid beta and ApoE blood biomarkers combined with patient age (PrecivityAD® blood test) in symptomatic patients evaluated for Alzheimer's disease (AD) or other causes of cognitive decline. The Quality Improvement and Clinical Utility PrecivityAD Clinician Survey (QUIP I, ClinicalTrials.gov Identifier: NCT05477056) was a prospective, single-arm cohort study among 366 patients evaluated by neurologists and other cognitive specialists. Participants underwent blood biomarker testing and received an amyloid probability score (APS), indicating the likelihood of a positive result on an amyloid positron emission tomography (PET) scan. The primary study outcomes were appropriateness of patient selection as well as result interpretation associated with PrecivityAD blood testing. A 95% (347/366) concordance rate was noted between clinicians' patient selection and the test's intended use criteria. In the final analysis including these 347 patients (median age 75 years, 56% women), prespecified test result categories incorporated 133 (38%) low APS, 162 (47%) high APS, and 52 (15%) intermediate APS patients. Clinicians' pretest and posttest AD diagnosis probability changed from 58% to 23% in low APS patients and 71% to 89% in high APS patients (p 
ISSN:2328-9503
2328-9503
DOI:10.1002/acn3.51863