ArticleAlzheimer's research & therapy2019
Impact of a clinical decision support tool on prediction of progression in early-stage dementia: a prospective validation study.
Article in Alzheimer's research & therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Limited generalizability and high risk of bias in multivariable models predicting conversion risk from mild cognitive impairment to dementia: A systematic review.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Pooled it
- Technical and clinical validation of commercial automated volumetric MRI tools for dementia diagnosis-a systematic review.Neuroradiology · 2021Pooled it
- Clinical decision support for potentially sedating drugs in palliative care: a mixed-methods pilot study.BMC palliative care · 2026Article
- The Digitized Memory Clinic.Nature reviews. Neurology · 2024Review
- Use of a digital tool to support the diagnostic process in memory clinics-a usability study.Alzheimer's research & therapy · 2024Article
- Removing outliers from the normative database improves regional atrophy detection in single-subject voxel-based morphometry.Neuroradiology · 2024Article
- Article
- Expert validation of prediction models for a clinical decision-support system in audiology.Frontiers in neurology · 2022Article
- Impact of normative brain volume reports on the diagnosis of neurodegenerative dementia disorders in neuroradiology: A real-world, clinical practice study.Frontiers in aging neuroscience · 2022Article
- Observational
- Clinician Preimplementation Perspectives of a Decision-Support Tool for the Prediction of Cardiac Arrhythmia Based on Machine Learning: Near-Live Feasibility and Qualitative Study.JMIR human factors · 2021Article
- Ethical Implications of Alzheimer's Disease Prediction in Asymptomatic Individuals through Artificial Intelligence.Diagnostics (Basel, Switzerland) · 2021Article
- Use of a Decision Support Tool on Prognosis of Work Ability in Work Disability Assessments: An Experimental Study Among Insurance Physicians.Journal of occupational rehabilitation · 2021Article
- Shaping a data-driven era in dementia care pathway through computational neurology approaches.BMC medicine · 2020Review
- Normative brain volume reports may improve differential diagnosis of dementing neurodegenerative diseases in clinical practice.European radiology · 2020Article
- Accuracy and Effects of Clinical Decision Support Systems Integrated With BMJ Best Practice-Aided Diagnosis: Interrupted Time Series Study.JMIR medical informatics · 2020Article
- Cognitively supernormal older adults maintain a unique structural connectome that is resistant to Alzheimer's pathology.NeuroImage. Clinical · 2020Article
- cCOG: A web-based cognitive test tool for detecting neurodegenerative disorders.Alzheimer's & dementia (Amsterdam, Netherlands) · 2020Article
- Evaluating 2-[NeuroImage. Clinical · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 7 institutions in 5 countries.
Funding
Abstract
backgroundIn clinical practice, it is often difficult to predict which patients with cognitive complaints or impairment will progress or remain stable. We assessed the impact of using a clinical decision support system, the PredictND tool, to predict progression in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI) in memory clinics.
methodsIn this prospective multicenter study, we included 429 patients with SCD (n = 230) and MCI (n = 199) (female 54%, age 67 ± 9, MMSE 28 ± 2) and followed them for at least 12 months. Based on all available patient baseline data (demographics, cognitive tests, cerebrospinal fluid biomarkers, and MRI), the PredictND tool provides a comprehensive overview of the data and a classification defining the likelihood of progression. At baseline, a clinician defined an expected follow-up diagnosis and estimated the level of confidence in their prediction using a visual analogue scale (VAS, 0-100%), first without and subsequently with the PredictND tool. As outcome measure, we defined clinical progression as progression from SCD to MCI or dementia, and from MCI to dementia. Correspondence between the expected and the actual clinical progression at follow-up defined the prognostic accuracy.
resultsAfter a mean follow-up time of 1.7 ± 0.4 years, 21 (9%) SCD and 63 (32%) MCI had progressed. When using the PredictND tool, the overall prognostic accuracy was unaffected (0.4%, 95%CI - 3.0%; + 3.9%; p = 0.79). However, restricting the analysis to patients with more certain classifications (n = 203), we found an increase of 3% in the accuracy (95%CI - 0.6%; + 6.5%; p = 0.11). Furthermore, for this subgroup, the tool alone showed a statistically significant increase in the prognostic accuracy compared to the evaluation without tool (6.4%, 95%CI 2.1%; 10.7%; p = 0.004). Specifically, the negative predictive value was high. Moreover, confidence in the prediction increased significantly (∆VAS = 4%, p < .0001).
conclusionsAdding the PredictND tool to the clinical evaluation increased clinicians' confidence. Furthermore, the results indicate that the tool has the potential to improve prediction of progression for patients with more certain classifications.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.