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When looking in PubMed, one sees that there is an exponential increase in the number of studies on biomarkers for AD, and the opportunities should be excellent for making meta-analyses on the topic. However, if one sets out to curate the literature, it will rapidly become clear that there is no standardized way of reporting how tests were performed, on what patients, how samples were handled, how cut-points were determined, etc. This is a well-known problem in other fields of medicine, which stimulated the creation of the STARD (STAndards for the Reporting of Diagnostic accuracy studies) criteria some years ago.
The work now to adapt the STARD criteria to studies on neurodegenerative diseases is very important. In my mind, the first draft of the STARDdem document was rather naïve in respect to what is important to know for fluid biomarkers, which is my specialty. For imaging biomarkers and other measures to help in making the diagnosis, the situation may be the same. I think that it is very important that specialists respond to the invitation by the STARDdem authors to read...
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When looking in PubMed, one sees that there is an exponential increase in the number of studies on biomarkers for AD, and the opportunities should be excellent for making meta-analyses on the topic. However, if one sets out to curate the literature, it will rapidly become clear that there is no standardized way of reporting how tests were performed, on what patients, how samples were handled, how cut-points were determined, etc. This is a well-known problem in other fields of medicine, which stimulated the creation of the STARD (STAndards for the Reporting of Diagnostic accuracy studies) criteria some years ago.
The work now to adapt the STARD criteria to studies on neurodegenerative diseases is very important. In my mind, the first draft of the STARDdem document was rather naïve in respect to what is important to know for fluid biomarkers, which is my specialty. For imaging biomarkers and other measures to help in making the diagnosis, the situation may be the same. I think that it is very important that specialists respond to the invitation by the STARDdem authors to read and comment on the draft to make the first public version as good as possible.
 View all comments by Henrik Zetterberg |
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This is an exciting and timely project that will benefit scientific research and clinical practice in the long run.
One difficulty I can foresee is that dementia is a long, pathological process rather than an event. So it would be very hard to define a "standard" point of "conversion" from "MCI" or "pre-AD" to dementia. The distinction between MCI and dementia depends on an individual's "function" compared to a previous level. The comparison is often subject to clinical judgment, and, in certain contexts, making a good judgment can be very difficult.
"MCI" also suffers from lack of a standard "operational" definition. For example, one person could be labeled as amnestic MCI, non-amnestic MCI/single- or multiple-domain MCI, based on poor performance on neuropsychological tests, but in reality, it is almost impossible to standardize the number of tests, types of tests, and which norm to be compared to in defining MCI.
View all comments by Lei Feng |
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