Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Atrium Health, Charlotte, North Carolina, USA.
Alzheimers Dement. 2024 Nov;20(11):8209-8215. doi: 10.1002/alz.14150. Epub 2024 Oct 6.
Diagnosing Alzheimer's disease (AD) poses significant challenges to health care, often resulting in delayed or inadequate patient care. The clinical integration of blood-based biomarkers (BBMs) for AD holds promise in enabling early detection of pathology and timely intervention. However, several critical considerations, such as the lack of consistent guidelines for assessing cognition, limited understanding of BBM test characteristics, insufficient evidence on BBM performance across diverse populations, and the ethical management of test results, must be addressed for widespread clinical implementation of BBMs in the United States. The Global CEO Initiative on Alzheimer's Disease BBM Workgroup convened to address these challenges and provide recommendations that underscore the importance of evidence-based guidelines, improved training for health-care professionals, patient empowerment through informed decision making, and the necessity of community-based studies to understand BBM performance in real-world populations. Multi-stakeholder engagement is essential to implement these recommendations and ensure credible guidance and education are accessible to all stakeholders.
诊断阿尔茨海默病(AD)给医疗保健带来了重大挑战,往往导致患者护理延迟或不充分。血液生物标志物(BBM)在 AD 中的临床应用有望实现对病理学的早期检测和及时干预。然而,在美国广泛临床应用 BBM 时,必须考虑到一些关键问题,如评估认知的一致性指南缺乏、对 BBM 测试特征的理解有限、不同人群中 BBM 性能的证据不足,以及测试结果的伦理管理。全球首席执行官阿尔茨海默病 BBM 工作组召集会议,以应对这些挑战,并提出建议,强调了循证指南的重要性、加强对医疗保健专业人员的培训、通过知情决策增强患者权能,以及进行基于社区的研究以了解 BBM 在实际人群中的性能的必要性。多利益相关方的参与对于实施这些建议以及确保所有利益相关方都能获得可信的指导和教育至关重要。