Biological Diagnosis of Alzheimer’s Disease Based on Amyloid Status: An Illustration of Confirmation Bias in Medical Research?
Abstract
:1. A Concise Historical Account of Alzheimer’s Disease Discoveries (Figure 1)
2. Advancing towards a Biological Framework for Defining Alzheimer’s Disease
3. Interpretation of a Core Biomarker: Cholesterol against Amyloid Peptide (Figure 3)
4. A potential Confirmation Bias in the Search for Alzheimer’s Biomarkers
5. The Impact on the Search for AD Biomarkers and Treatments
5.1. Challenges in Precision Medicine: Treatment Complexity in Alzheimer’s Disease
5.2. Expanding Alzheimer’s Understanding beyond Amyloid: Challenges and Opportunities
6. Breaking out of Confirmation Bias
7. Alternative Biomarkers and More Possibilities
8. Conclusions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Cochrane reviews titles | 18F PET with florbetapir for the early diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI) | 18F PET with flutemetamol for the early diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI) | 18F PET with florbetaben for the early diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI) | 11C-PIB-PET for the early diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI) | Plasma and cerebrospinal fluid ABeta42 for the differential diagnosis of Alzheimer’s disease dementia in participants diagnosed with any dementia subtype in a specialist care setting | CSF tau and the CSF tau/ABeta ratio for the diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI) | Plasma and cerebrospinal fluid amyloid beta for the diagnosis of Alzheimer’s disease dementia and other dementias in people with mild cognitive impairment (MCI) | |||
First author | Martinez G. | Martinez G. | Martinez G. | Zhang S. | Kokkinou M. | Ritchie C. | Ritchie C. | |||
Publication year | 2017 | 2017 | 2017 | 2014 | 2021 | 2017 | 2014 | |||
Reference | [29] | [32] | [28] | [33] | [34] | [31] | [30] | |||
Stage of AD progression | MCI | MCI | MCI | MCI | Dementia | MCI | MCI | |||
Type of Assay | PET Imaging | PET Imaging | PET Imaging | PET Imaging | CSF Assay | CSF Assay | CSF Assay | CSF Assay | Plasma Assay | Plasma Assay |
Biomarkers | florbetapir | flutemetamol | florbetaben | PIB | CSF Aβ42 | p-tau | total tau | Aβ42 | Aβ42/Aβ40 | Aβ42 |
Number of research papers | 3 | 1 | 1 | 9 | 13 | 15 | 14 | 1 | 1 | |
Numbers of Participants | 448 | 224 | 45 | 274 | 1704 | 1282 | 1349 | 562 | 565 | |
Sensitivity (%) | 67 | 64 | 100 | 96 | 79 | 82 | 77 | 81 | 86 | 86 |
Specificty (%) | 71 | 69 | 88 | 58 | 60 | 47.5 | 72 | 64 | 70 | 50 |
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Souchet, B.; Michaïl, A.; Billoir, B.; Braudeau, J. Biological Diagnosis of Alzheimer’s Disease Based on Amyloid Status: An Illustration of Confirmation Bias in Medical Research? Int. J. Mol. Sci. 2023, 24, 17544. https://doi.org/10.3390/ijms242417544
Souchet B, Michaïl A, Billoir B, Braudeau J. Biological Diagnosis of Alzheimer’s Disease Based on Amyloid Status: An Illustration of Confirmation Bias in Medical Research? International Journal of Molecular Sciences. 2023; 24(24):17544. https://doi.org/10.3390/ijms242417544
Chicago/Turabian StyleSouchet, Benoît, Alkéos Michaïl, Baptiste Billoir, and Jérôme Braudeau. 2023. "Biological Diagnosis of Alzheimer’s Disease Based on Amyloid Status: An Illustration of Confirmation Bias in Medical Research?" International Journal of Molecular Sciences 24, no. 24: 17544. https://doi.org/10.3390/ijms242417544