Introduction: Further evidence is needed to support the use of plasma amyloid β (Aβ) biomarkers as Alzheimer's disease prescreening tools. This study evaluated the clinical performance and robustness of plasma Aβ /Aβ for amyloid positivity prescreening.
Methods: Data were collected from 333 BioFINDER and 121 Alzheimer's Disease Neuroimaging Initiative study participants. Risk and predictive values versus percentile of plasma Aβ /Aβ evaluated the actionability of plasma Aβ /Aβ , and simulations modeled the impact of potential uncertainties and biases. Amyloid PET was the brain amyloidosis reference standard.
Results: Elecsys plasma Aβ /Aβ could potentially rule out amyloid pathology in populations with low-to-moderate amyloid positivity prevalence. However, simulations showed small measurement or pre-analytical errors in Aβ and/or Aβ cause misclassifications, impacting sensitivity or specificity. The minor fold change between amyloid PET positive and negative cases explains the biomarkers low robustness.
Discussion: Implementing plasma Aβ /Aβ for routine clinical use may pose significant challenges, with misclassification risks.
Highlights: Plasma Aβ /Aβ ruled out amyloid PET positivity in a setting of low amyloid-positive prevalence. Including (pre-) analytical errors or measurement biases caused misclassifications. Plasma Aβ /Aβ had a low inherent dynamic range, independent of analytical method. Other blood biomarkers may be easier to implement as robust prescreening tools.
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http://dx.doi.org/10.1002/alz.12801 | DOI Listing |
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