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. 2018 Aug 17:10:509-518.
doi: 10.1016/j.dadm.2018.07.003. eCollection 2018.

Evaluating combinations of diagnostic tests to discriminate different dementia types

Marie Bruun  1 , Hanneke F M Rhodius-Meester  2 , Juha Koikkalainen  3 , Marta Baroni  4 , Le Gjerum  1 , Afina W Lemstra  2 , Frederik Barkhof  5   6 , Anne M Remes  7   8 , Timo Urhemaa  9 , Antti Tolonen  9 , Daniel Rueckert  10 , Mark van Gils  9 , Kristian S Frederiksen  1 , Gunhild Waldemar  1 , Philip Scheltens  2 , Patrizia Mecocci  4 , Hilkka Soininen  11 , Jyrki Lötjönen  3 , Steen G Hasselbalch  1 , Wiesje M van der Flier  2   12
Affiliations

Evaluating combinations of diagnostic tests to discriminate different dementia types

Marie Bruun et al. Alzheimers Dement (Amst). .

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.

Keywords: Alzheimer's disease; Biomarkers; CSF; Clinical decision support system; Dementia with Lewy bodies; Diagnostic test assessment; Differential diagnosis; Frontotemporal dementia; MRI; Vascular dementia.

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