New Blood Test for Alzheimer Disease

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Discussion Overview

The discussion centers around a new blood test for Alzheimer's Disease that detects phospho-tau217 (p-tau217) in blood plasma, as reported in a recent article from the Journal of the American Medical Association. Participants explore the implications of the test's specificity and sensitivity, particularly in the context of early detection and potential interventions.

Discussion Character

  • Exploratory
  • Technical explanation
  • Debate/contested

Main Points Raised

  • Some participants highlight that the test shows over 80% specificity and could be predictive of Alzheimer's Disease up to 20 years in advance.
  • Others argue that with 80% specificity, the test could yield significantly more false positives than true positives when screening the general population, even with 100% sensitivity.
  • A participant notes that the population of potential positives could be enriched for true positives by adjusting the prevalence assumption from 0.1 to 0.55.
  • There is a suggestion that early detection through such testing could lead to early intervention strategies, including pharmacological treatments and lifestyle changes, despite the absence of a cure.

Areas of Agreement / Disagreement

Participants express differing views on the implications of the test's specificity and sensitivity, particularly regarding the balance of false positives to true positives. The discussion remains unresolved regarding the overall effectiveness and practicality of the test in a general population screening context.

Contextual Notes

Limitations include assumptions about population prevalence and the potential impact of false positives on the perceived effectiveness of the test.

Tom.G
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The Journal of the American Medical Association (JAMA) today (7/28/2020) published an article on using presence of phospho-tau217 (p-tau217) in blood plasma to detect Alzheimers Disease. Over 80% specificity, and early results look like it could be predictive up to 20 years.

doi:10.1001/jama.2020.12134
or
https://jamanetwork.com/journals/jama/fullarticle/2768841

Cheers,
Tom
 
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About 10% of people 65 or older has Alzheimer's, so in a population of 100, there will be 10 with Alzheimer's and 90 negatives. With 80% specificity, 18 of the negatives will test positive (false positive) versus the 10 true positives in the sample. Even with 100% sensitivity, screening the general population with a test that has 80% specificity would give close to a 1.8x as many false positives as true positives.
 
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Ygggdrasil said:
Even with 100% sensitivity, screening the general population with a test that has 80% specificity would give close to a 1.8x as many false positives as true positives.
Yikes, that's not good.
 
Your population of potential positives would be enriched for true positives by going from 0.1 to 0.55.
 
I think the assumption on testing like this is: early detection allows for early intervention. Pharmacology, life style changes, and diet are all considerations. There is no cure, just increased quality of life.
 

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