决策树有助于对阿尔茨海默病中脑脊液生物标志物进行解读。
Decision tree supports the interpretation of CSF biomarkers in Alzheimer's disease.
作者信息
Babapour Mofrad Rosha, Schoonenboom Niki S M, Tijms Betty M, Scheltens Philip, Visser Pieter Jelle, van der Flier Wiesje M, Teunissen Charlotte E
机构信息
Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam UMC, Amsterdam, the Netherlands.
Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
出版信息
Alzheimers Dement (Amst). 2018 Nov 12;11:1-9. doi: 10.1016/j.dadm.2018.10.004. eCollection 2019 Dec.
INTRODUCTION
We developed and validated a clinically applicable decision tree for the use of cerebrospinal fluid biomarkers in the diagnosis of Alzheimer's disease (AD).
METHODS
Subjects with probable AD ( = 1004) and controls ( 442) were included. A decision tree was modeled using Classification And Regression Tree analysis in a training cohort (AD 221; controls 221) and validated in an independent cohort (AD = 783; controls = 221). Diagnostic performance was compared to previously defined cutoffs (amyloid β 1-42 < 813 pg/ml; tau>375 pg/ml).
RESULTS
Two cerebrospinal fluid AD biomarker profiles were revealed: the "classical" AD biomarker profile (amyloid β 1-42: 647-803 pg/ml; tau >374 pg/ml) and an "atypical" AD biomarker profile with strongly decreased amyloid β 1-42 (<647 pg/ml) and normal tau concentrations (<374 pg/ml). Compared to previous cutoffs, the decision tree performed better on diagnostic accuracy (86% [84-88] vs 80% [78-83]).
DISCUSSION
Two cerebrospinal fluid AD biomarker profiles were identified and incorporated in a readily applicable decision tree, which improved diagnostic accuracy.
引言
我们开发并验证了一种临床适用的决策树，用于脑脊液生物标志物在阿尔茨海默病（AD）诊断中的应用。
方法
纳入可能患有AD的受试者（n = 1004）和对照组（n = 442）。在一个训练队列（AD = 221；对照组 = 221）中使用分类与回归树分析对决策树进行建模，并在一个独立队列（AD = 783；对照组 = 221）中进行验证。将诊断性能与先前定义的临界值（淀粉样β蛋白1-42 < 813 pg/ml；tau > 375 pg/ml）进行比较。
结果
揭示了两种脑脊液AD生物标志物谱：“经典”AD生物标志物谱（淀粉样β蛋白1-42：647-803 pg/ml；tau > 374 pg/ml）和一种“非典型”AD生物标志物谱，其淀粉样β蛋白1-42显著降低（< 647 pg/ml）且tau浓度正常（< 374 pg/ml）。与先前的临界值相比，决策树在诊断准确性方面表现更好（86% [84-88] 对 80% [78-83]）。
讨论
识别出两种脑脊液AD生物标志物谱并将其纳入一个易于应用的决策树中，提高了诊断准确性。
Zotero 插件