Evidence map›Paper›PMID 39297292›Full record

Trial reportInternational psychogeriatrics2024

Measuring clinically relevant change in apathy symptoms in ADMET and ADMET 2.

Shankar Tumati, Nathan Herrmann, Jaime Perin, Paul B Rosenberg, Alan J Lerner, Jacobo Mintzer, Prasad R Padala, Olga Brawman-Mintzer, Christopher H van Dyck, Anton P Porsteinsson and 4 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International psychogeriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

14 authors.

Shankar TumatiSunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
Nathan HerrmannSunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
Jaime PerinJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Paul B RosenbergJohns Hopkins School of Medicine, Baltimore, MD, USA.ORCID 0000-0003-1106-4299
Alan J LernerUniversity Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Jacobo MintzerRalph H. Johnson VA Medical Center, Medical University of South Carolina, Charleston, SC, USA.
Prasad R PadalaCentral Arkansas Veterans Healthcare System, University of Arkansas for Medical Sciences, Little Rock, AR, USA.ORCID 0000-0003-1921-9806
Olga Brawman-MintzerRalph H. Johnson VA Medical Center, Medical University of South Carolina, Charleston, SC, USA.
Christopher H van DyckYale School of Medicine, New Haven, CT, USA.
Anton P PorsteinssonUniversity of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
Suzanne CraftWake Forest University, Winston-Salem, NC, USA.
Allan LeveyEmory Goizueta Alzheimer's Disease Research Center, Atlanta, GA, USA.
David ShadeJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Krista L LanctôtSunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.ORCID 0000-0001-7024-6637

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Wake Forest University School of Medicine Alzheimer's Disease Research CenterP30AG072947 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI SHANNON L RISACHER · 2021 to 2026
$24.3M
Apathy in Alzheimer's Disease Methyphenidate Trial II (ADMET II)R01AG046543 · NIA · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI HERRMANN, NATHAN, LANCTOT, KRISTA L. · 2014 to 2018
$8.1M
Apathy in Alzheimer's Disease Methylphenidate TrialR01AG033032 · NIA · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI LANCTOT, KRISTA L., MINTZER, JACOBO · 2009 to 2010
$1.4M
PET imaging of activated microglia in Alzheimer's DiseaseK08AG029157 · NIA · JOHNS HOPKINS UNIVERSITY · PI ROSENBERG, PAUL B · 2008 to 2012
$539k
NCATS NIH HHS UL1 TR001863NIA NIH HHS K08 AG029157NIA NIH HHS P30 AG072947NIA NIH HHS R01 AG033032NIA NIH HHS R01 AG046543
6 · The paper itself

Abstract

objectivesAmong participants with Alzheimer's disease (AD) we estimated the minimal clinically important difference (MCID) in apathy symptom severity on three scales.

designRetrospective anchor- and distribution-based analyses of change in apathy symptom scores.

settingApathy in Dementia Methylphenidate Trial (ADMET) and ADMET 2 randomized controlled trials conducted at three and ten clinics specialized in dementia care in United States and Canada, respectively.

participantsTwo hundred and sixty participants (60 ADMET, 200 ADMET 2) with clinically significant apathy in Alzheimer's disease. MEASUREMENTS: The Clinical Global Impression of Change in Apathy scale was used as the anchor measure and the MCID on the Neuropsychiatric Inventory - Apathy (NPI-A), Dementia Apathy Interview and Rating (DAIR), and Apathy Evaluation Scale-Informant (AES-I) were estimated with linear mixed models across all study visits. The estimated thresholds were evaluated with performance metrics.

resultsAmong the MCID was a decrease of four points (95% CI: -4.0 to -4.8) on the NPI-A, 0.56 points (95% CI: -0.47 to -0.65) on the DAIR, and three points on the AES-I (95% CI: -0.9 to -5.4). Distribution-based analyses were largely consistent with the anchor-based analyses. The MCID across the three measures showed ∼60% accuracy. Sensitivity analyses found that MMSE scores and apathy severity at baseline influenced the estimated MCID.

conclusionsMCIDs for apathy on three scales will help evaluate treatment efficacy at the individual level. However, the modest correspondence between MCID and clinical impression of change suggests the need to consider other scales.

Indexed as

Alzheimer DiseaseApathyMethylphenidatePsychiatric Status Rating ScalesAgedAged, 80 and overCanadaCentral Nervous System StimulantsFemaleHumansMaleMinimal Clinically Important DifferenceNeuropsychological TestsRetrospective StudiesSeverity of Illness IndexUnited StatesCentral Nervous System StimulantsMethylphenidateAlzheimer’s diseaseApathybehavioral and psychological symptoms of dementia (BPSD)clinical assessmentrating scales

Identifiers

PMID39297292
PMCPMC11695175

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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.