Evaluating the Performance of Different Criteria in Diagnosing AD and Preclinical AD with the Bayesian Latent Class Model

X. Wang, G. Niu, J. Zhao, H. Zhu, F. Li, J. Tian, Z. Zhang, G. Chen, Y. He, Qi Gao
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Abstract

Background

The diagnostic criteria for Alzheimer’s disease (AD) should be highly sensitive and specific. Clinicians have varying opinions on the different criteria, including the International Working Group-1 (IWG-1), International Working Group-2 (IWG-2), and AT(N) criteria. Few studies had evaluated the performance of these criteria in diagnosing AD and preclinical AD when the gold standard was absent.

Methods

We estimated and compared the performance of these criteria in diagnosing AD using data from 908 subjects in the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Additionally, 622 subjects were selected to evaluate and compare the performance of IWG-2 and AT(N) criteria in diagnosing preclinical AD. A novel approach, Bayesian latent class models with fixed effect dependent, was utilized to estimate the diagnostic accuracy of these criteria in detecting different AD statuses simultaneously.

Results

The sensitivity of the IWG-1, IWG-2, and AT(N) criteria in diagnosing AD was 0.850, 0.836, and 0.665. The specificity of these criteria was 0.788, 0.746, and 0.747. The IWG-1 criteria had the highest Youden Index in detecting AD. When diagnosing preclinical AD, the sensitivity of the IWG-2 and AT(N) criteria was 0.797 and 0.955. The specificity of these criteria was 0.922 and 0.720. The IWG-2 criteria had the highest Youden Index.

Conclusion

IWG-1 was more suitable than the IWG-2 and AT(N) criteria in detecting AD. IWG-2 criteria was more suitable than AT(N) criteria in detecting preclinical AD.

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用贝叶斯潜类模型评估诊断注意力缺失症和临床前注意力缺失症的不同标准的性能
背景阿尔茨海默病(AD)的诊断标准应具有高度敏感性和特异性。临床医生对包括国际工作组-1(IWG-1)、国际工作组-2(IWG-2)和AT(N)标准在内的不同标准有不同的看法。我们利用阿尔茨海默病神经影像学倡议(ADNI)中 908 名受试者的数据,评估并比较了这些标准在诊断 AD 和临床前 AD 中的表现。此外,我们还选择了622名受试者来评估和比较IWG-2和AT(N)标准在诊断临床前AD中的表现。结果IWG-1、IWG-2和AT(N)标准诊断AD的灵敏度分别为0.850、0.836和0.665。这些标准的特异性分别为 0.788、0.746 和 0.747。IWG-1标准在检测AD方面的尤登指数最高。在诊断临床前AD时,IWG-2和AT(N)标准的灵敏度分别为0.797和0.955。这些标准的特异性分别为 0.922 和 0.720。结论IWG-1比IWG-2和AT(N)更适合检测AD。IWG-2标准比AT(N)标准更适合检测临床前AD。
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来源期刊
The Journal of Prevention of Alzheimer's Disease
The Journal of Prevention of Alzheimer's Disease Medicine-Psychiatry and Mental Health
CiteScore
9.20
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0.00%
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期刊介绍: The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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