ArticleAlzheimer's & dementia (New York, N. Y.)
Blood-based biomarker prescreening with different testing combinations and cutoffs: A simulation study examining efficacy and cost-effectiveness in Alzheimer's disease prevention studies.
Article in Alzheimer's & dementia (New York, N. Y.). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Cost analyses of plasma p-tau217 versus p-tau217/Aβ42 ratio using two-step approach in the Japanese health care system.The journal of prevention of Alzheimer's disease · 2026Article
- Translating blood-based biomarkers into Alzheimer's disease clinical practice: screening, diagnosis, and longitudinal monitoring.Frontiers in aging neuroscience · 2026Review
- Blood-based biomarker prescreening with different testing combinations and cutoffs: A simulation study examining efficacy and cost-effectiveness in Alzheimer's disease prevention studies.Alzheimer's & dementia (New York, N. Y.)Article
- Immediate reactions to amyloid PET disclosure in Japanese older adults without dementia.Alzheimer's & dementia (New York, N. Y.)Article
- Characterizing Japanese older adults without dementia by amyloid PET status: A comparative study of amyloid-positive and amyloid-negative groups from Japanese trial-ready cohort study.Alzheimer's & dementia (Amsterdam, Netherlands)Article
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Authors and funding
6 authors.
Funding
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Abstract
introductionBlood-based biomarkers (BBBMs), including plasma amyloid beta (Aβ) or phosphorylated tau (p-tau), combined with apolipoprotein E (
methodsWe conducted a simulation study utilizing data from our ongoing Japanese Trial-Ready Cohort (J-TRC) onsite study (
resultsApplying BBBM prescreening significantly decreased sensitivity and increased specificity and PPV compared to the no-prescreening scenario. Although no single model was superior in all performance metrics, a trade-off between sensitivity and specificity was observed. Generalized linear models (GLMs) simultaneously incorporating plasma Aβ42/Aβ40 ratio and p-tau217 showed a balanced efficacy (the best level of improvement in number needed to screen (NNS) but modest worsening in sensitivity) and the best level of cost-effectiveness compared to other models, although there were substantial overlaps in their 95% confidence intervals (CIs). The minimum-required PET/BBBM cost ratio to achieve improved cost-effectiveness by employing the prescreening process was negatively associated with the background prevalence of amyloid positivity. DISCUSSION: The choice of prescreening strategy in AD prevention studies/trials should be tailored to specific trial requirements, considering the relative importance of sensitivity versus cost-effectiveness, local testing cost environments, and background population characteristics. Highlights: We investigated different models of blood-based biomarker (BBBM) prescreening.Data from Japanese Trial-Ready Cohort Study were used for simulation.BBBM reduced the number needed to screen with positron emission tomography (PET) but decreased the sensitivity.The cost-effectiveness improved with a higher PET/BBBM cost ratio.No single model was optimal for all scenarios.
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