文摘
摘要目的:波士顿的诊断性能评估标准版本2.0脑淀粉样血管病(CAA)诊断在一群人的无症状性脑出血或CAA-related瞬态局部神经发作(TFNE)和曾为CAA病理评估。
背景:波士顿标准最近更新将non-hemorrhagic MRI CAA和小血管疾病的生物标记物。更新后的标准(v2.0)演示了改进诊断产量相比之前的版本的标准(v1.5)患者出现症状CAA-related综合症。然而,这些标准没有被验证在任何没有CAA症状群。
设计/方法:54个参与者的平均年龄为75,随后在大人群或观察性研究,包括如果他们临死前的MRI与gradient-recall回波序列和随后的大脑解剖与创新艺人经纪公司的评估。波士顿标准版本的性能与v1.5使用病理证实创新艺人经纪公司作为参考标准。使用逻辑回归计算性能的措施。成对的AUC比较使用pROC包R。
结果:总的来说,28/54的参与者病理证实创新艺人经纪公司(即严重CAA至少1皮质区域)。波士顿标准v2.0的敏感性和特异性分别为78.6%(59.1 - -91.7)和34.6%(17.2 - -55.7)诊断任何创新艺人经纪公司(可能+可能的;AUC: 0.57)和28.6%(13.2 - -48.7)和69.2% (48.2 - -85.7),0.49 (AUC),可能的创新艺人经纪公司诊断。v2.0波士顿有优越的精度标准前v1.5任何创新艺人经纪公司诊断标准(AUC 0.57(0.45 - -0.69)和AUC 0.43 (0.30 - -0.56),Z= 2.10,p= 0.03)。
结论:波士顿CAA标准v2.0有限精度诊断在无症状的人群中。额外的生物标志物可能需要探讨在此设置优化创新艺人经纪公司的诊断性能。
披露:瑞士人博士没有披露。Charidimou博士已经收到个人薪酬在5000 - 9999美元的范围作为顾问必须照顾。Charidimou博士已经收到个人薪酬在500 - 4999美元的范围作为一个编辑,副主编,爱思唯尔或编辑顾问委员会成员,神经科学杂志》上。迈克博士没有披露。斯科特Przybelski没有披露。盖Lesnick已收到个人赔偿作为梅奥诊所的一名雇员。Vemuri博士已经收到个人薪酬在500 - 4999美元的范围为在演讲人米勒医疗服务通信公司. .Vemuri博士的机构收到NIH的研究支持。罗斯Reichard的机构收到NIH的研究支持。罗斯的直系亲属成员Reichard已经收到相关出版物的出版版税卫生保健。 Dr. Rabinstein has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boston Scientific. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra Zeneca. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NovoNordisk. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurocritical care/NCS-Springer. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wolters/UptoDate. Dr. Rabinstein has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for EBSCO/DynaMed. Dr. Rabinstein has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AHA. The institution of Dr. Rabinstein has received research support from EyeBox. The institution of Dr. Rabinstein has received research support from Chiesi. The institution of Dr. Rabinstein has received research support from Alexion. Dr. Rabinstein has received publishing royalties from a publication relating to health care. Dr. Rabinstein has received publishing royalties from a publication relating to health care. Dr. Rabinstein has received publishing royalties from a publication relating to health care. Dr. Rabinstein has received publishing royalties from a publication relating to health care. Dr. Knopman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for DIAN TU study. The institution of Dr. Knopman has received research support from NIH. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Petersen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Nestle. Dr. Petersen has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech, Inc.. Dr. Petersen has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche, Inc.. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Petersen has received publishing royalties from a publication relating to health care. Dr. Graff-Radford has received personal compensation for serving as an employee of Mayo Clinic. Dr. Graff-Radford has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NINDS/NIH. Dr. Graff-Radford has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Academy of Neurology. The institution of Dr. Graff-Radford has received research support from NIH.
