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, 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

Department of Clinical Medicine

11 Citations (Scopus)

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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 language	English
Journal	Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume	10
Pages (from-to)	509-518
Number of pages	10
ISSN	2352-8729
DOIs	https://doi.org/10.1016/j.dadm.2018.07.003
Publication status	Published - 2018

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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, 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

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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.",

author = "Marie Bruun and Rhodius-Meester, {Hanneke F M} and Juha Koikkalainen and Marta Baroni and Le Gjerum and Lemstra, {Afina W} and Frederik Barkhof and Remes, {Anne M} and Timo Urhemaa and Antti Tolonen and Daniel Rueckert and {van Gils}, Mark and Frederiksen, {Kristian S} and Gunhild Waldemar and Philip Scheltens and Patrizia Mecocci and Hilkka Soininen and Jyrki L{\"o}tj{\"o}nen and Hasselbalch, {Steen G} and {van der Flier}, {Wiesje M}",

year = "2018",

doi = "10.1016/j.dadm.2018.07.003",

language = "English",

volume = "10",

pages = "509--518",

journal = "Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring",

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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

Y1 - 2018

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.

U2 - 10.1016/j.dadm.2018.07.003

DO - 10.1016/j.dadm.2018.07.003

M3 - Journal article

C2 - 30320203

SN - 2352-8729

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

ER -

Evaluating combinations of diagnostic tests to discriminate different dementia types

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