Evaluating combinations of diagnostic tests to discriminate different dementia types

Marie Bruun; 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

doi:10.1016/j.dadm.2018.07.003

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 journal › Article › Scientific › peer-review

9 Citations (Scopus)

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 language	English
Pages (from-to)	509-518
Number of pages	10
Journal	Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume	10
DOIs	https://doi.org/10.1016/j.dadm.2018.07.003
Publication status	Published - 1 Jan 2018
MoE publication type	Not Eligible

Keywords

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

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Bruun, M., Rhodius-Meester, H. F. M., Koikkalainen, J., Baroni, M., Gjerum, L., Lemstra, A. W., Barkhof, F., Remes, A. M., Urhemaa, T., Tolonen, A., Rueckert, D., van Gils, M., Frederiksen, K. S., Waldemar, G., Scheltens, P., Mecocci, P., Soininen, H., Lötjönen, J., Hasselbalch, S. G., & 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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title = "Evaluating combinations of diagnostic tests to discriminate different dementia types",

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.",

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

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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 journal › Article › Scientific › peer-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.

PY - 2018/1/1

Y1 - 2018/1/1

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.

AB - 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.

KW - Alzheimer's disease

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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