P3–463: “Dad's back” – treatment effect and personality in Alzheimer's patients enrolled in a multi–center galantamine trial
Bibliographic record
Abstract
Anecdotal reports suggest that an important but formally undetected treatment effect described by caregivers and patients is the return of the person they knew pre–onset of AD (“Dad's back”). We investigated whether this treatment effect occurred in the VISTA database. We studied 75 mild to moderate AD patients who participated in the Video Imaging Synthesis of Treating Alzheimer's disease (VISTA) Study, a 4–month, multi–center, parallel group double–blind placebo–controlled trial of galantamine (16–24 mg/day) with a 4–month open label follow–up. Standard efficacy parameters were captured at baseline and followed monthly and, in addition, the patient and primary caregiver participated in the Clinician's Interview Based Impression of Change–Plus Caregiver Input (CIBIC–Plus) and Goal Attainment Scaling (GAS), which were digitally videotaped and then qualitatively coded. Searches, blinded to treatment effect assignment, were carried out on the baseline data for 75 patients, looking for reports of change in personality (e.g. “she used to be the life of the party”) and then tracking these at two and four months, to look for their return. 27 of 75 patients (36%) were reported at baseline to have declined in an area characteristic to them. (“He was so funny, but he's lost his sense of humour.”) 48 problem areas were found in these 27 patients. Of these 48, 27 (56%) were in interpersonal behavior and relations (socializing, socially inappropriate behaviors, irritation with others), 8 (17%) were in functional areas, 7 (15%) were in cognitive areas, 4 (8%) in leisure activities and 2 (4%) in areas of behavior not affecting socializing (e.g. hoarding). By month four, 12 patients (44%) had improved in at least one problem area, 8 (30%) had maintained and 5(19%) had. 2 patients (7%) terminated. Anecdotal reports of patient's personality changing with onset of AD and returning to some degree after treatment are borne out in this subset of the VISTA database. In most cases, the description of the problem fits into the area of social behaviors and interactions. 44% patients were reported to be more like their old selves by month four.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".