The Bayesian approach for real‐world implementation of plasma p‐tau217 in tertiary care memory clinics in Thailand
Alzheimer s & Dementia,
Journal Year:
2024,
Volume and Issue:
20(9), P. 6456 - 6467
Published: July 17, 2024
Abstract
INTRODUCTION
Plasma
phosphorylated
tau
(p‐tau)217
is
a
promising
biomarker
for
Alzheimer's
disease
(AD)
diagnosis,
but
its
clinical
implementation
remains
challenging.
We
propose
strategy
based
on
Bayes’
theorem
and
test
it
in
real‐life
memory
clinics.
METHODS
Memory
clinic
patients
were
evaluated
by
neurocognitive
specialists
prespecified
diagnosis
subsequently
underwent
blood
collection
p‐tau217,
cerebrospinal
fluid,
or
amyloid
positron
emission
tomography.
Using
cross‐validation,
the
Bayesian
approach
(pretest
probability
×
individualized
likelihood
ratio)
was
compared
to
other
models
AD
diagnosis.
RESULTS
The
demonstrated
an
area
under
receiver
operating
characteristic
curve
(AUC)
of
0.98
(95%
confidence
interval
[CI]:
0.96–1.0),
significantly
outperforming
multivariable
logistic
regression
(p‐tau217,
age,
apolipoprotein
E;
AUC
0.95,
p
=
0.024)
p‐tau217
alone
(AUC
0.94,
0.007).
When
applying
two‐threshold
approach,
yielded
accuracy
0.94
CI:
0.88–1.0)
without
requiring
confirmatory
tests
62.9%
iterations.
DISCUSSION
offers
effective
flexible
address
limitations
plasma
practice.
Highlights
Incorporating
pretest
into
interpretation
improves
diagnostic
performance
significantly.
could
obviate
need
testing
most
patients.
proves
useful
as
low‐
middle‐income
country
such
Thailand.
Language: Английский
Diagnostic accuracy of phosphorylated tau217 in detecting Alzheimer's disease pathology among cognitively impaired and unimpaired: A systematic review and meta‐analysis
Alzheimer s & Dementia,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Dec. 23, 2024
Abstract
Our
review
summarizes
the
diagnostic
accuracy
of
plasma
and
cerebrospinal
fluid
(CSF)
phosphorylated
tau
217
(p‐tau217)
in
detecting
amyloid
pathology
on
positron
emission
tomography
(PET).
We
systematically
reviewed
studies
that
reported
CSF
p‐tau217,
searching
MEDLINE/PubMed,
Scopus,
Web
Science
through
August
2024.
The
p‐tau217
predicting
PET
was
evaluated
30
studies.
Both
effectively
detect
deposition.
Plasma
showed
82%
sensitivity
for
83%
tau,
with
86%
specificity,
respectively.
had
79%
91%
84%
specificity.
identifies
Alzheimer's
disease
(AD)
pathology.
comparable
to
deposition
PET.
Despite
being
less
sensitive
PET,
can
be
an
efficient
screening
tool
underlying
AD
Highlights
serves
as
a
viable
biomarker
alternative
due
strong
concordance
between
their
results.
accurately
(PET)
positivity,
exhibiting
low
rate
false
negatives
positives,
thereby
establishing
it
reliable
(AD).
demonstrates
slightly
higher
positivity
compared
positivity.
predictive
among
cognitively
impaired
individuals,
unimpaired
suggesting
its
enhanced
utility
clinical
settings.
Language: Английский