Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, USA.
Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, California, USA.
Alzheimers Dement. 2024 Oct;20(10):6834-6843. doi: 10.1002/alz.14160. Epub 2024 Aug 13.
Well-chosen biomarkers have the potential to increase the efficiency of clinical trials and drug discovery and should show good precision as well as clinical validity.
We suggest measures that operationalize these criteria and describe a general approach that can be used for inference-based comparisons of biomarker performance. The methods are applied to measures obtained from structural magnetic resonance imaging (MRI) from individuals with mild dementia (n = 70) or mild cognitive impairment (MCI; n = 303) enrolled in the Alzheimer's Disease Neuroimaging Initiative.
Ventricular volume and hippocampal volume showed the best precision in detecting change over time in both individuals with MCI and with dementia. Differences in clinical validity varied by group.
The methodology presented provides a standardized framework for comparison of biomarkers across modalities and across different methods used to generate similar measures and will help in the search for the most promising biomarkers.
A framework for comparison of biomarkers on pre-defined criteria is presented. Criteria for comparison include precision in capturing change and clinical validity. Ventricular volume has high precision in change for both dementia and mild cognitive impairment (MCI) trials. Imaging measures' performance in clinical validity varies more for dementia than for MCI.
精心选择的生物标志物有可能提高临床试验和药物发现的效率,并且应该具有良好的精度和临床有效性。
我们提出了一些操作性强的措施,并描述了一种通用方法,可用于基于推断的生物标志物性能比较。该方法应用于阿尔茨海默病神经影像学倡议中轻度痴呆(n=70)或轻度认知障碍(MCI;n=303)个体的结构磁共振成像(MRI)获得的测量值。
在 MCI 和痴呆患者中,脑室体积和海马体体积在检测随时间变化方面表现出最佳的精度。临床有效性的差异因组别而异。
提出的方法为跨模态和跨不同方法生成类似测量值的生物标志物提供了标准化的比较框架,并将有助于寻找最有前途的生物标志物。
提出了一个基于预定义标准的生物标志物比较框架。比较标准包括捕捉变化的精度和临床有效性。脑室体积在痴呆和轻度认知障碍(MCI)试验中都具有很高的变化精度。影像学测量在临床有效性方面的表现因痴呆而比 MCI 更具多样性。