10.6084/m9.figshare.5277745.v1
Pontecorvo M.J.
Pontecorvo
M.J.
Siderowf A.
Siderowf
A.
Dubois B.
Dubois
B.
Doraiswamy P.M.
Doraiswamy
P.M.
Frisoni G.B.
Frisoni
G.B.
Grundman M.
Grundman
M.
Nobili F.
Nobili
F.
Sadowsky C.H.
Sadowsky
C.H.
Salloway S.
Salloway
S.
Arora A.K.
Arora
A.K.
Chevrette A.
Chevrette
A.
Deberdt W.
Deberdt
W.
Dell'Agnello G.
Dell'Agnello
G.
Flitter M.
Flitter
M.
Galante N.
Galante
N.
Lowrey M.J.
Lowrey
M.J.
Lu M.
Lu
M.
McGeehan A.
McGeehan
A.
Devous Sr. M.D.
Devous
Sr.
Mintun M.A.
Mintun
M.A.
Supplementary Material for: Effectiveness of Florbetapir PET Imaging in Changing Patient Management
Karger Publishers
2017
Alzheimer disease
Amyloid
Diagnosis
Differential diagnosis
Florbetapir
2017-08-04 09:13:33
Dataset
https://karger.figshare.com/articles/dataset/Supplementary_Material_for_Effectiveness_of_Florbetapir_PET_Imaging_in_Changing_Patient_Management/5277745
<p><b><i>Aims:</i></b> To evaluate the impact of amyloid PET imaging on
diagnosis and patient management in a multicenter, randomized,
controlled study. <b><i>Methods:</i></b> Physicians identified patients
seeking a diagnosis for mild cognitive impairment or dementia, possibly
due to Alzheimer disease (AD), and recorded a working diagnosis and a
management plan. The patients underwent florbetapir PET scanning and
were randomized to either immediate or delayed (1-year) feedback
regarding amyloid status. At the 3-month visit, the physician updated
the diagnosis and recorded a summary of the actual patient management
since the post-scan visit. The study examined the impact of immediate
versus delayed feedback on patient diagnosis/management at 3 and 12
months. <b><i>Results:</i></b> A total of 618 subjects were randomized
(1:1) to immediate or delayed feedback arms, and 602 subjects completed
the 3-month primary endpoint visit. A higher proportion of patients in
the immediate feedback arm showed a change in diagnosis compared to the
controls (32.6 vs. 6.4%; <i>p</i> = 0.0001). Similarly, a higher
proportion of patients receiving immediate feedback had a change in
management plan (68 vs. 55.5%; <i>p</i> < 0.002), mainly driven by
changes in AD medication. Specifically, acetylcholinesterase inhibitors
were prescribed to 67% of the amyloid-positive and 27% of the
amyloid-negative subjects in the information group compared with 56 and
43%, respectively, in the control group (<i>p</i> < 0.0001). These between-group differences persisted until the 12-month visit. <b><i>Conclusion:</i></b> Knowledge of the amyloid status affects the diagnosis and alters patient management.</p>