Evaluating combinations of diagnostic tests to discriminate different dementia types

Marie Bruun (Corresponding Author), Hanneke F.M. Rhodius-Meester, Juha Koikkalainen, Marta Baroni, Le Gjerum, Afina W. Lemstra, Frederik Barkhof, Anne M. Remes, Timo Urhemaa, Antti Tolonen, Daniel Rueckert, Mark van Gils, Kristian S. Frederiksen, Gunhild Waldemar, Philip Scheltens, Patrizia Mecocci, Hilkka Soininen, Jyrki Lötjönen, Steen G. Hasselbalch, Wiesje M. van der Flier

Research output: Contribution to journalArticleScientificpeer-review

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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.

Original languageEnglish
Pages (from-to)509-518
Number of pages10
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume10
DOIs
Publication statusPublished - 1 Jan 2018
MoE publication typeNot Eligible

Fingerprint

Routine Diagnostic Tests
Dementia
Lewy Body Disease
Frontotemporal Dementia
Vascular Dementia
Cerebrospinal Fluid
Alzheimer Disease
Magnetic Resonance Imaging
Multicenter Studies
Differential Diagnosis
Biomarkers

Keywords

  • Alzheimer's disease
  • Biomarkers
  • Clinical decision support system
  • CSF
  • Dementia with Lewy bodies
  • Diagnostic test assessment
  • Differential diagnosis
  • Frontotemporal dementia
  • MRI
  • Vascular dementia

Cite this

Bruun, M., Rhodius-Meester, H. F. M., Koikkalainen, J., Baroni, M., Gjerum, L., Lemstra, A. W., ... van der Flier, W. M. (2018). Evaluating combinations of diagnostic tests to discriminate different dementia types. Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, 10, 509-518. https://doi.org/10.1016/j.dadm.2018.07.003
Bruun, Marie ; Rhodius-Meester, Hanneke F.M. ; 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. / Evaluating combinations of diagnostic tests to discriminate different dementia types. In: Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring. 2018 ; Vol. 10. pp. 509-518.
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Bruun, M, Rhodius-Meester, HFM, Koikkalainen, J, Baroni, M, Gjerum, L, Lemstra, AW, Barkhof, F, Remes, AM, Urhemaa, T, Tolonen, A, Rueckert, D, van Gils, M, Frederiksen, KS, Waldemar, G, Scheltens, P, Mecocci, P, Soininen, H, Lötjönen, J, Hasselbalch, SG & van der Flier, WM 2018, 'Evaluating combinations of diagnostic tests to discriminate different dementia types', Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, vol. 10, pp. 509-518. https://doi.org/10.1016/j.dadm.2018.07.003

Evaluating combinations of diagnostic tests to discriminate different dementia types. / Bruun, Marie (Corresponding Author); Rhodius-Meester, Hanneke F.M.; 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.

In: Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring, Vol. 10, 01.01.2018, p. 509-518.

Research output: Contribution to journalArticleScientificpeer-review

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T1 - Evaluating combinations of diagnostic tests to discriminate different dementia types

AU - Bruun, Marie

AU - Rhodius-Meester, Hanneke F.M.

AU - Koikkalainen, Juha

AU - Baroni, Marta

AU - Gjerum, Le

AU - Lemstra, Afina W.

AU - Barkhof, Frederik

AU - Remes, Anne M.

AU - Urhemaa, Timo

AU - Tolonen, Antti

AU - Rueckert, Daniel

AU - van Gils, Mark

AU - Frederiksen, Kristian S.

AU - Waldemar, Gunhild

AU - Scheltens, Philip

AU - Mecocci, Patrizia

AU - Soininen, Hilkka

AU - Lötjönen, Jyrki

AU - Hasselbalch, Steen G.

AU - van der Flier, Wiesje M.

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N2 - 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.

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KW - Biomarkers

KW - Clinical decision support system

KW - CSF

KW - Dementia with Lewy bodies

KW - Diagnostic test assessment

KW - Differential diagnosis

KW - Frontotemporal dementia

KW - MRI

KW - Vascular dementia

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