Physicians' Assessment of the Clinical Utility of a Novel Test to Diagnose Alzheimer's Disease (AD)

Author(s)

Samson C1, Mark N1, Datar M1, Howell S2, Huie F3, Goss TF1
1Veranex Solutions, Boston, MA, USA, 2AIDS Healthcare Foundation, Santa Monica, CA, USA, 3Molina Health Plan, NY, NY, USA

Objectives: DISCERNTM is a novel test combining three biomarkers: Morphometric Imaging (measures fibroblasts ability to form networks), Protein Kinase C ε (measures synaptic growth), and AD-Index (measures phosphorylation of Erk1 and Erk2 in response to bradykinin). DISCERNTM is the only AD diagnostic validated against autopsy confirmed diagnosis (NIH gold standard for AD diagnosis) with 95% sensitivity and 95% specificity. This research explores the clinical utility of the novel DISCERNTM test.

Methods: A web survey-based conjoint analysis estimated preferences from a sample of PCPs, neurologists, and geriatricians. Hypothetical patient profiles were created with five attributes: MRI/CT Scan results, MMSE score, Blood test results (TSH, Vitamin B12, Folate, Syphilis, Lyme disease), Age, and DISCERNTM result. Physicians viewed seven randomly selected from a fractional factorial design of 27 unique profiles. For each patient, physicians indicated whether or not they would Diagnose AD, Prescribe medications for AD cognitive impairment, Refer to a neurologist (PCPs and geriatricians only) or Prescribe futuristic disease-modifying Drug X. Aggregate logit models assessed attribute importance.

Results: 402 physicians participated (250 PCPs, 102 Neurologists, 50 Geriatricians). Only 4% physicians indicated extreme satisfaction with current AD tests, and 90% were likely to order DISCERNTM. DISCERNTM was an important attribute in physician decision-making and compared to no DISCERNTM test a positive DISCERNTM result was associated with: significantly higher odds of AD diagnosis (relative attribute importance (RAI):64%; OR:6.45; 95% CI:5.09-8.17), prescribing Drug X (RAI:62%; OR:4.12; 95% CI:3.36-5.04), and prescribing treatments for cognitive impairment (RAI:54%; OR:2.98; 95% CI:2.40-3.68), respectively; a negative DISCERNTM test was associated with significantly lower odds of prescribing treatments for cognitive impairment (RAI:54%; OR:0.58; 95% CI:0.48-0.70), MMSE score was the most important attribute in decisions to refer to a neurologist (RAI:48%).

Conclusions: This implicit preference study indicates physicians will routinely use the results of DISCERNTM in the diagnosis and management of AD.

Conference/Value in Health Info

2022-05, ISPOR 2022, Washington, DC, USA

Code

MSR33

Topic

Economic Evaluation, Medical Technologies, Methodological & Statistical Research

Topic Subcategory

Diagnostics & Imaging, Survey Methods, Value of Information

Disease

Geriatrics

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