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Evaluating combinations of diagnostic tests to discriminate different dementia types

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

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

2018

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2018

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2018

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Journal Article

Evaluating combinations of diagnostic tests to discriminate different dementia types

Baroni, Marta,

van Gils, Mark,

Remes, Anne M.,

Waldemar, Gunhild,

van der Flier, Wiesje M.,

Urhemaa, Timo,

Lötjönen, Jyrki,

Koikkalainen, Juha,

Rhodius-Meester, Hanneke F.M.,

Mecocci, Patrizia,

Gjerum, Le,

Tolonen, Antti,

Frederiksen, Kristian S.,

Barkhof, Frederik,

Bruun, Marie,

Rueckert, Daniel,

Scheltens, Philip,

Soininen, Hilkka,

Lemstra, Afina W.,

Hasselbalch, Steen G.

2018

Overview

We studied, using a data-driven approach, how different combinations of diagnostic tests contribute to the differential diagnosis of dementia. 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. 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%. 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. •Performance of diagnostic tests in pairwise diagnostics differs by diagnostic groups.•Accuracy seems to increase when combining diagnostic tests.•Diagnostic groups might be better separated by different combinations of biomarkers.

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Publisher

Elsevier Inc,Elsevier,Wiley

Subject

Alzheimer's disease

/ Biomarkers

/ Clinical decision support system

/ CSF

/ Dementia with Lewy bodies

/ Diagnostic Assessment & Prognosis

/ Diagnostic test assessment