Assessment of mild cognitive dysfunction in patients with atrial fibrillation utilizing the R4Alz assessment test
Bibliographic record
Abstract
Abstract Background/Introduction The association between atrial fibrillation and cognitive dysfunction has accumulated a growing body of evidence in recent years. However, establishing such a diagnosis remains challenging, especially in mild oligosymptomatic patients. REMEDES for Alzheimer (R4Alz) is a novel test, designed to assess cognitive control decline at an early stage. Purpose We sought to evaluate the prevalence of early, mild cognitive dysfunction in patients with paroxysmal atrial fibrillation with the use of established and novel diagnostic tools. Methods This is a prospective cross-sectional study that enrolled consecutive patients with history of paroxysmal atrial fibrillation and matched healthy controls, from a tertiary cardiology department. Patients with history of stroke or known cognitive dysfunction of any type were excluded from the study. Demographic and clinical data were collected. All study participants were subjected to Montreal Cognitive Assessment (MoCA) and to R4Alz within the same day. Cognitive function and attention ability is assessed at three stages with R4Alz: working memory updating (R1), supervisory attention system (R2) and task/rule switching and control of inhibition (R3). The primary endpoint was the difference in cognitive function between patients with atrial fibrillation and controls. Secondary endpoints included the correlation between the two assessment tests in both groups. Statistical analysis was performed with R version 4.1.0 and a p-value<0.05 was considered statistically significant. Results Fifty-five patients with atrial fibrillation and thirty-four controls were enrolled in the study (Mean age: 62.6 y, Female gender: 62.9%). MoCA scores (25.4 ± 4.11 for patients with atrial fibrillation vs 22.3 ± 3.72 for healthy controls, p-value <0.001) (Figure 1) as well as scores of all stages of R4ALz {working memory (R1a, R1b, R1c), supervisory attention system (R2) and task/rule switching – inhibition control (R3a1, R3a2, R3b)} were indicative of mild cognitive dysfunction in patients with atrial fibrillation. The control group exhibited significantly better cognitive performance on all assessment tools (Table 1).Figure 1Table 1
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".