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 | |
| Publication status | Published - 1 Jan 2018 |
| MoE publication type | Not Eligible |
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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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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
TY - JOUR
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
UR - http://www.scopus.com/inward/record.url?scp=85054439727&partnerID=8YFLogxK
U2 - 10.1016/j.dadm.2018.07.003
DO - 10.1016/j.dadm.2018.07.003
M3 - Article
AN - SCOPUS:85054439727
VL - 10
SP - 509
EP - 518
JO - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
JF - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
SN - 2352-8729
ER -