O1–09–05: Further evaluation of the indications for the rational use of CSF in the diagnostics of Alzheimer's and related disorders
Bibliographic record
Abstract
Advancements in our understanding of the biology of Alzheimer's and related diseases culminated in the proposal of novel criteria for the clinical diagnosis of Alzheimer's disease. This research criteria reject the previous probabilistic diagnostic approach in favor of a confirmatory one. More specifically, they propose demonstrating some characteristic of Alzheimer's disease including amyloidogenesis and/or neurodegeneration in addition to the cognitive decline characteristic of Alzheimer's disease. It remains currently unclear what methods to demonstrate amyloidogenesis and/or neurodegeneration should be used at different points in the diagnostics of Alzheimer's and related diseases. We are prospectively recording all patients in our memory clinic that require cerebrospinal fluid analyses in the process of diagnosing the cause of their behavioral changes and cognitive decline. All our patients undergod behavioral and cognitive testing, neuropsychiatric exam, MRI including manual and semi-automated volumetry and when required cerebrospinal fluid analyses including basic cerebrospinal parameters, reibergrams, testing for infectious diseases, amyloid 1–42, tau, phospho-tau, neuron specific enolase, S100 and several markers of inflammation. Here we extend our findings presented last year in Vancouver by increasing the number of patients, by increasing in particular the number of healthy control subjects thus modifying further our cut-off values. Importantly several indications for cerebrospinal fluid analyses when diagnosing Alzheimer's and related disorders appear to emerge. Cerebrospinal fluid analyses is most useful when either cognitive profile in not typical of a specific Alzheimer's or related disorder or when MRI analyses fails to demonstrate neurodegenerative changes in the appropriate anatomical regions. In addition, the use of inflammatory markers might turn out to be of relevance in assessing some of the causes and possibly the rate of progression of neurodegeneration. Our data suggest that cerebrospinal fluid analyses should be performed primarily in cases when cognitive decline and/or MRI imaging fail to meet the requirements proposed in novel research clinical diagnostic criteria for Alzheimer's and related diseases.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".