Do Beliefs about the Pathogenetic Role of Amyloid Affect the Interpretation of Amyloid PET in the Clinic

Marina Boccardi, Daniele Altomare, Clarissa Ferrari, Cristina Festari, Luigi Antelmi, Michela Pievani, Anna Tarallo, Cristina Muscio, Ugo P. Guerra, Barbara Paghera, Alessandro Padovani, Giovanni B. Frisoni, INDIA-FBP Working Group

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Beliefs of dementia experts about the pathogenic role of amyloid in Alzheimer's disease (AD) may affect the use of amyloid positron emission tomography (PET).

OBJECTIVE: To assess the role attributed to amyloid in AD pathogenesis by Italian dementia experts, and whether this modulates the impact of amyloid PET results in their diagnostic workup.

METHODS: 22 dementia experts rated their beliefs about the pathogenic role of amyloid. Then, we asked them to rate the probability of change in diagnosis based on the result of amyloid PET for 7 case vignettes, depicting patients who initially received a diagnosis based on a comprehensive workup and later received amyloid PET results consistent or inconsistent with the clinical picture.

RESULTS: 55% of the experts assigned a dominant role to amyloid, and 32% attributed a similar role to amyloid and tau in AD pathogenesis. The probability of change in diagnosis ranged from 17% (SD = 21.6) for cases with consistent to 51% (SD = 34) for cases with inconsistent PET versus clinical data. Diagnostic change was not biased by the clinicians' beliefs about AD pathogenesis.

CONCLUSIONS: This work supports an unbiased interpretation of amyloid PET across different beliefs about the pathogenic role of amyloid, and a belief-independent reluctance to change diagnosis in cases where change is expected and recommended.

Original languageEnglish
Pages (from-to)111-117
Number of pages7
JournalNeurodegenerative Diseases
Volume16
Issue number1-2
DOIs
Publication statusPublished - 2016

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Amyloid
Positron-Emission Tomography
Alzheimer Disease
Dementia

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Do Beliefs about the Pathogenetic Role of Amyloid Affect the Interpretation of Amyloid PET in the Clinic. / Boccardi, Marina; Altomare, Daniele; Ferrari, Clarissa; Festari, Cristina; Antelmi, Luigi; Pievani, Michela; Tarallo, Anna; Muscio, Cristina; Guerra, Ugo P.; Paghera, Barbara; Padovani, Alessandro; Frisoni, Giovanni B.; INDIA-FBP Working Group.

In: Neurodegenerative Diseases, Vol. 16, No. 1-2, 2016, p. 111-117.

Research output: Contribution to journalArticle

Boccardi, M, Altomare, D, Ferrari, C, Festari, C, Antelmi, L, Pievani, M, Tarallo, A, Muscio, C, Guerra, UP, Paghera, B, Padovani, A, Frisoni, GB & INDIA-FBP Working Group 2016, 'Do Beliefs about the Pathogenetic Role of Amyloid Affect the Interpretation of Amyloid PET in the Clinic', Neurodegenerative Diseases, vol. 16, no. 1-2, pp. 111-117. https://doi.org/10.1159/000439255
Boccardi, Marina ; Altomare, Daniele ; Ferrari, Clarissa ; Festari, Cristina ; Antelmi, Luigi ; Pievani, Michela ; Tarallo, Anna ; Muscio, Cristina ; Guerra, Ugo P. ; Paghera, Barbara ; Padovani, Alessandro ; Frisoni, Giovanni B. ; INDIA-FBP Working Group. / Do Beliefs about the Pathogenetic Role of Amyloid Affect the Interpretation of Amyloid PET in the Clinic. In: Neurodegenerative Diseases. 2016 ; Vol. 16, No. 1-2. pp. 111-117.
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abstract = "BACKGROUND: Beliefs of dementia experts about the pathogenic role of amyloid in Alzheimer's disease (AD) may affect the use of amyloid positron emission tomography (PET).OBJECTIVE: To assess the role attributed to amyloid in AD pathogenesis by Italian dementia experts, and whether this modulates the impact of amyloid PET results in their diagnostic workup.METHODS: 22 dementia experts rated their beliefs about the pathogenic role of amyloid. Then, we asked them to rate the probability of change in diagnosis based on the result of amyloid PET for 7 case vignettes, depicting patients who initially received a diagnosis based on a comprehensive workup and later received amyloid PET results consistent or inconsistent with the clinical picture.RESULTS: 55{\%} of the experts assigned a dominant role to amyloid, and 32{\%} attributed a similar role to amyloid and tau in AD pathogenesis. The probability of change in diagnosis ranged from 17{\%} (SD = 21.6) for cases with consistent to 51{\%} (SD = 34) for cases with inconsistent PET versus clinical data. Diagnostic change was not biased by the clinicians' beliefs about AD pathogenesis.CONCLUSIONS: This work supports an unbiased interpretation of amyloid PET across different beliefs about the pathogenic role of amyloid, and a belief-independent reluctance to change diagnosis in cases where change is expected and recommended.",
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AU - Antelmi, Luigi

AU - Pievani, Michela

AU - Tarallo, Anna

AU - Muscio, Cristina

AU - Guerra, Ugo P.

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AU - Padovani, Alessandro

AU - Frisoni, Giovanni B.

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