Ackley Sarah F, Wang Jingxuan, Chen Ruijia, Hill-Jarrett Tanisha G, Rojas-Saunero L Paloma, Stokes Andrew, Shah Sachin J, Glymour M Maria
Department of Epidemiology, Brown University, Providence, Rhode Island, USA.
Department of Epidemiology & Biostatistics, UCSF, San Francisco, California, USA.
Alzheimers Dement. 2025 Feb;21(2):e14597. doi: 10.1002/alz.14597.
Studies use multiple different instruments to measure dementia-related outcomes, making head-to-head comparisons of interventions difficult.
To address this gap, we developed two methods to crosswalk estimated treatment effects on cognitive outcomes that are flexible, broadly applicable, and do not rely on strong distributional assumptions.
We present two methods to crosswalk effect estimates using one measure to estimates using another measure, illustrated with global cognitive measures from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Specifically, we develop crosswalks for the following measures and associated change scores over time: the clinical dementia rating scale sum of box (CDR-SB), Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE) scores. Finally, a setting in which crosswalking is not appropriate is illustrated with plasma phosphorylated tau (p-tau) concentration and global cognitive measures.
Given the inconsistent collection and reporting of dementia and cognitive outcomes across studies, these crosswalking methods offer a valuable approach to harmonizing and comparing results reported on different scales.
Developed methods to crosswalk from one cognitive outcome to another in studies of dementia interventions. Methods illustrated using combinations of global cognitive tests: the CDR-SB, MoCA, and MMSE. Illustrates scenarios where crosswalking may not be appropriate for certain combinations of measures. Crosswalking methods support comparison of interventions with accurate error propagation. Facilitates inclusion of more studies in meta-analyses by increasing data comparability.
多项研究使用多种不同工具来测量与痴呆症相关的结果，这使得对干预措施进行直接比较变得困难。
为填补这一空白，我们开发了两种方法来对认知结果的估计治疗效果进行相互转换，这两种方法灵活、广泛适用且不依赖于强分布假设。
我们提出了两种将一种测量方法的效应估计值转换为另一种测量方法的效应估计值的方法，并以阿尔茨海默病神经影像倡议（ADNI）的整体认知测量为例进行说明。具体而言，我们针对以下测量方法及随时间的相关变化分数开发了相互转换方法：临床痴呆评定量表总和（CDR-SB）、蒙特利尔认知评估量表（MoCA）和简易精神状态检查表（MMSE）分数。最后，以血浆磷酸化tau蛋白（p-tau）浓度和整体认知测量为例，说明了相互转换不适用的情况。
鉴于不同研究中痴呆症和认知结果的收集与报告不一致，这些相互转换方法为协调和比较不同量表上报告的结果提供了一种有价值的方法。
在痴呆症干预研究中开发了从一种认知结果转换为另一种认知结果的方法。使用整体认知测试组合（CDR-SB、MoCA和MMSE）对方法进行了说明。说明了某些测量组合相互转换可能不适用的情况。相互转换方法支持对干预措施进行比较，并能准确传播误差。通过提高数据可比性，有助于在荟萃分析中纳入更多研究。
