Will biomarker-based diagnosis of Alzheimer's disease maximize scientific progress? Evaluating proposed diagnostic criteria.

Will biomarker-based diagnosis of Alzheimer's disease maximize scientific progress? Evaluating proposed diagnostic criteria.
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DOI:
10.1007/s10654-018-0418-4
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发表时间:
2018-07
影响因子:
13.6
通讯作者:
Manly JJ
Manly JJ
中科院分区:
医学1区
文献类型:
--
作者:
Glymour MM;Brickman AM;Kivimaki M;Mayeda ER;Chêne G;Dufouil C;Manly JJ

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最近发表的用于在研究中诊断阿尔茨海默病(AD)的框架将允许仅基于两种生物标志物(β-淀粉样蛋白和病理性tau)进行诊断,即使在没有客观或主观记忆或认知变化的人中也是如此。这一修订将对未来的阿尔茨海默氏症研究产生重大影响,在广泛采用之前,这些变化应该得到严格的评估。我们提出了三个原则来评估AD诊断框架的任何修订:1)修订是否提高了诊断的有效性; 2)修订是否提高了诊断的可靠性或降低了诊断的费用; 3)修订将促进跨人群的创新和严格的研究。新的诊断框架不太可能实现这些目标中的任何一个。相反,它有可能阻碍未来的研究人员,并减缓确定预防或治疗AD的有效策略的进展。
A recently published framework for the diagnosis of Alzheimer’s Disease (AD) in research studies would allow diagnosis on the sole basis of two biomarkers (β-amyloid and pathologic tau), even in people with no objective or subjective memory or cognitive changes. This revision will have substantial implications for future Alzheimer’s research, and the changes should be rigorously evaluated before widespread adoption. We propose three principles for evaluating any revision to diagnostic frameworks for AD: 1) does the revision improve the validity of the diagnosis; 2) does the revision improve the reliability or reduce the expense of the diagnosis; and 3) will the revision foster innovative and rigorous research across populations. The new diagnostic framework is unlikely to achieve any of these goals. Instead, it has the potential to handicap future researchers, and slow progress towards identifying effective strategies to prevent or treat AD.
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