Evidence map›Paper›PMID 17760991›Full record

ArticleBMC neurology2007

The clinical meaningfulness of ADAS-Cog changes in Alzheimer's disease patients treated with donepezil in an open-label trial.

Kenneth Rockwood, Sherri Fay, Mary Gorman, Daniel Carver, Janice E Graham

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC neurology, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Minimal clinically important difference in Alzheimer's disease: Rapid review.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024
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  5. Donepezil for dementia due to Alzheimer's disease.The Cochrane database of systematic reviews · 2018
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  7. Clinical significance in dementia research: a review of the literature.American journal of Alzheimer's disease and other dementias · 2014
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kenneth RockwoodDivision of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, Canada. Kenneth.Rockwood@Dal.ca
Sherri Fay
Mary Gorman
Daniel Carver
Janice E Graham

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 6-month anti-dementia drug trials, a 4-point change in the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) is held to be clinically important. We examined how this change compared with measures of clinical meaningfulness.

methodsThis is a secondary analysis of a 12 month open-label study of 100 patients (71 women) diagnosed with mild to moderate AD treated with 5-10 mg of donepezil daily. We studied the observed case, 6-month change from baseline on the ADAS-Cog, the Clinician's Interview Based Impression of Change-Plus Caregiver Input (CIBIC-Plus), patient-Goal Attainment Scaling (PGAS) and clinician-GAS (CGAS).

resultsAt 6 months, donepezil-treated patients (n = 95) were more likely to show no change (+/- 3 points) on the ADAS-Cog (56%) than to improve (20%) or decline (24%) by 4-points. ADAS-Cog change scores were little correlated with other measures: from -0.09 for PGAS to 0.27 for the CIBIC-Plus. While patients who improved on the ADAS-Cog were less likely to decline on the clinical measures (26%), 43% of patients who declined on the ADAS-Cog improved on at least two of the clinical measures.

conclusionThe ADAS-Cog did not capture all clinically important effects. In general, ADAS-Cog improvement indicates clinical improvement, whereas many people with ADAS-Cog decline do not show clinical decline. The open-label design of this study does not allow us to know whether this is a treatment effect, which requires further investigation.

Indexed as

Severity of Illness IndexActivities of Daily LivingAgedAged, 80 and overAlzheimer DiseaseCholinesterase InhibitorsClinical Trials as TopicDonepezilFemaleHumansIndansMaleMiddle AgedNootropic AgentsPiperidinesTreatment OutcomeCholinesterase InhibitorsDonepezilIndansNootropic AgentsPiperidines

Identifiers

PMID17760991
PMCPMC2034585

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.