Liu 2010.
| Study characteristics | |||
| Patient sampling |
Primary objectives: determine predictors of conversion to AD from MCI with automated MRI regional cortical volume and thickness measures Study population: amnestic MCI Selection criteria: data were collected from 6 medical centres across Europe. All the MCI participants had successfully undergone MRI and cognitive tests evaluated at baseline, and clinical evaluation and cognitive tests were repeated 1 year later. None of the MCI and AD participants had other neurological or psychiatric disease, significant unstable systemic illness or organ failure, and alcohol or substance misuse Study design: prospective longitudinal study (data from AddNeuroMed study; Lovestone 2009) |
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| Patient characteristics and setting |
Clinical presentations: amnestic MCI according to Petersen 1999 and Petersen 2001 criteria:
Age mean (SD): MCI who progressed to AD: 72 ± 6; stable MCI: 74 ± 6 Gender (% men): MCI who progressed to AD: 57%; stable MCI: 44% Education years mean (SD): MCI who progressed to AD 9 ± 4; stable MCI: 9 ± 4 ApoEϵ4 carriers (%): not stated Neuropsychological tests: MMSE mean (SD): MCI who progressed to AD: 27 ± 2; stable MCI: 27 ± 2 Clinical stroke excluded: not specified Co‐morbidities: not reported Number enrolled: 100 Number available for analysis: 100 Setting: AddNeuroMed cohort (Lovestone 2009) Country: Finland, Italy, Greece, UK, Poland, France Period: not reported Language: English |
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| Index tests |
Index test: MRI automated method for estimation of hippocampal volume Manufacturer: 6 different MRI systems (4 Signa, GE, Waukesha, WI; 1 Avanto, Siemen, Erlangen, Germany; and 1 Edge 1.5T, Picker, Cleveland, OH) Tesla strength: 1.5 Assessment methods: a highly automated structural MRI image processing pipeline, which was developed by Fischl and his colleagues was utilised for data analysis (Fischl 2004). It produced both regional cortical thickness measures from 34 areas and regional volume measures from 24 areas, including the hippocampus Description of positive cases definition by index test as reported: not specified Examiners: details not reported Interobserver variability: not provided |
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| Target condition and reference standard(s) |
Target condition: AD Prevalence of AD in the sample: 21/100 (21% of enrolled participants) Stable MCI or converted to other dementia: 79 (79%) stable MCI Reference standards: NINCDS/ADRDA criteria (McKhann 1984). Mean clinical follow‐up: 1 year |
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| Flow and timing |
Withdrawals explained and losses to follow‐up: none reported Uninterpretable MRI results have not been reported |
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| Comparative | |||
| Key conclusions by the authors | The cortical volumes achieved higher diagnostic accuracy than did cognitive tests or cortical thickness. Combining the volumes, thickness, and cognitive tests did not improve the test accuracy. The volume of amygdala and caudate were independent variables in predicting conversion from MCI to dementia due to AD | ||
| Conflict of interests | The authors declared no conflicts of interest | ||
| Notes |
Source of funding: the study was funded by the European Union, AddNeuroMed/Innovative Medicines LSHB‐CT‐2005‐518170; Yawu Liu was funded by Health Research Council of the Academy of Finland, grant 121038, and EVO grants 577209 and 5772720 from Kuopio University Hospital 2 x 2 table: data from the published article; only hippocampal volume measure was considered for the review purpose |
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| Methodological quality | |||
| Item | Authors' judgement | Risk of bias | Applicability concerns |
| DOMAIN 1: Patient Selection | |||
| Was a consecutive or random sample of patients enrolled? | No | ||
| Was a case‐control design avoided? | Yes | ||
| Did the study avoid inappropriate exclusions? | Yes | ||
| High | Low | ||
| DOMAIN 2: Index Test All tests | |||
| Were the index test results interpreted without knowledge of the results of the reference standard? | Unclear | ||
| Did the study provide a clear pre‐specified definition of what was considered to be a "positive" result of the index test? | No | ||
| Was the index test performed by a single operator or interpreted by consensus in a joint session? | Unclear | ||
| High | Low | ||
| DOMAIN 3: Reference Standard | |||
| Is the reference standards likely to correctly classify the target condition? | Yes | ||
| Were the reference standard results interpreted without knowledge of the results of the index tests? | Yes | ||
| Low | Low | ||
| DOMAIN 4: Flow and Timing | |||
| Was there an appropriate interval between index test and reference standard? | Yes | ||
| Did all patients receive the same reference standard? | Yes | ||
| Were all patients included in the analysis? | Yes | ||
| Low | |||