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Xavier Bonfill Cosp - One of the best experts on this subject based on the ideXlab platform.
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18f pet with florbetaben for the early diagnosis of alzheimer s disease Dementia and other Dementias in people with mild cognitive impairment mci
Cochrane Database of Systematic Reviews, 2017Co-Authors: Gabriel Martinez, Paulina Fuentes Padilla, Xavier Bonfill Cosp, Leon Flicker, Javier Zamora, Robin W M VernooijAbstract:Background 18F-florbetaben uptake by brain tissue, measured by positron emission tomography (PET), is accepted by regulatory agencies like the Food and Drug Administration (FDA) and the European Medicine Agencies (EMA) for assessing amyloid load in people with Dementia. Its added value is mainly demonstrated by excluding Alzheimer's pathology in an established Dementia diagnosis. However, the National Institute on Aging and Alzheimer's Association (NIA-AA) revised the diagnostic criteria for Alzheimer's disease and confidence in the diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease may be increased when using some amyloid biomarkers tests like 18F-florbetaben. These tests, added to the MCI core clinical criteria, might increase the diagnostic test accuracy (DTA) of a testing strategy. However, the DTA of 18F-florbetaben to predict the progression from MCI to Alzheimer’s disease Dementia (ADD) or other Dementias has not yet been systematically evaluated. Objectives To determine the DTA of the 18F-florbetaben PET scan for detecting people with MCI at time of performing the test who will clinically progress to ADD, other forms of Dementia (non-ADD), or any form of Dementia at follow-up. Search methods The most recent search for this review was performed in May 2017. We searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), BIOSIS Citation Index (Thomson Reuters Web of Science), Web of Science Core Collection, including the Science Citation Index (Thomson Reuters Web of Science) and the Conference Proceedings Citation Index (Thomson Reuters Web of Science), LILACS (BIREME), CINAHL (EBSCOhost), ClinicalTrials.gov (https://clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (http://www.who.int/ictrp/search/en/). We also searched ALOIS, the Cochrane Dementia & Cognitive Improvement Group’s specialised register of Dementia studies (http://www.medicine.ox.ac.uk/alois/). We checked the reference lists of any relevant studies and systematic reviews, and performed citation tracking using the Science Citation Index to identify any additional relevant studies. No language or date restrictions were applied to electronic searches. Selection criteria We included studies that had prospectively defined cohorts with any accepted definition of MCI at time of performing the test and the use of 18F-florbetaben scan to evaluate the DTA of the progression from MCI to ADD or other forms of Dementia. In addition, we only selected studies that applied a reference standard for Alzheimer’s Dementia diagnosis, for example, the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) or Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Data collection and analysis We screened all titles and abstracts identified in electronic-database searches. Two review authors independently selected studies for inclusion and extracted data to create two-by-two tables, showing the binary test results cross-classified with the binary reference standard. We used these data to calculate sensitivities, specificities, and their 95% confidence intervals. Two independent assessors performed quality assessment using the QUADAS-2 tool plus some additional items to assess the methodological quality of the included studies. Main results Progression from MCI to ADD, any other form of Dementia, and any form of Dementia was evaluated in one study (Ong 2015). It reported data on 45 participants at four years of follow-up; 21 participants met NINCDS-ADRDA criteria for Alzheimer’s disease Dementia at four years of follow-up, the proportion converting to ADD was 47% of the 45 participants, and 11% of the 45 participants met criteria for other types of Dementias (three cases of FrontoTemporal Dementia (FTD), one of Dementia with Lewy body (DLB), and one of Progressive Supranuclear Palsy (PSP)). We considered the study to be at high risk of bias in the domains of the reference standard, flow, and timing (QUADAS-2). MCI to ADD; 18F-florbetaben PET scan analysed visually: the sensitivity was 100% (95% confidence interval (CI) 84% to 100%) and the specificity was 83% (95% CI 63% to 98%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 100% (95% CI 84% to 100%) and the specificity was 88% (95% CI 68% to 97%) for the diagnosis of ADD at follow-up (n = 45, 1 study). MCI to any other form of Dementia (non-ADD); 18F-florbetaben PET scan analysed visually: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 38% (95% CI 23% to 54%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 40% (95% CI 25% to 57%) for the diagnosis of any other form of Dementia at follow-up (n = 45, 1 study). MCI to any form of Dementia;18F-florbetaben PET scan analysed visually: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 79% (95% CI 54% to 94%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 84% (95% CI 60% to 97%) for the diagnosis of any form of Dementia at follow-up (n = 45, 1 study). Authors' conclusions Although we were able to calculate one estimation of DTA in, especially, the prediction of progression from MCI to ADD at four years follow-up, the small number of participants implies imprecision of sensitivity and specificity estimates. We cannot make any recommendation regarding the routine use of 18F-florbetaben in clinical practice based on one single study with 45 participants. 18F-florbetaben has high financial costs, therefore, clearly demonstrating its DTA and standardising the process of the 18F-florbetaben modality are important prior to its wider use.
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The Cochrane Library - 18F PET with florbetaben for the early diagnosis of Alzheimer's disease Dementia and other Dementias in people with mild cognitive impairment (MCI).
Cochrane Database of Systematic Reviews, 2017Co-Authors: Gabriel Martinez, Paulina Fuentes Padilla, Leon Flicker, Javier Zamora, Robin W M Vernooij, Xavier Bonfill CospAbstract:Background 18F-florbetaben uptake by brain tissue, measured by positron emission tomography (PET), is accepted by regulatory agencies like the Food and Drug Administration (FDA) and the European Medicine Agencies (EMA) for assessing amyloid load in people with Dementia. Its added value is mainly demonstrated by excluding Alzheimer's pathology in an established Dementia diagnosis. However, the National Institute on Aging and Alzheimer's Association (NIA-AA) revised the diagnostic criteria for Alzheimer's disease and confidence in the diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease may be increased when using some amyloid biomarkers tests like 18F-florbetaben. These tests, added to the MCI core clinical criteria, might increase the diagnostic test accuracy (DTA) of a testing strategy. However, the DTA of 18F-florbetaben to predict the progression from MCI to Alzheimer’s disease Dementia (ADD) or other Dementias has not yet been systematically evaluated. Objectives To determine the DTA of the 18F-florbetaben PET scan for detecting people with MCI at time of performing the test who will clinically progress to ADD, other forms of Dementia (non-ADD), or any form of Dementia at follow-up. Search methods The most recent search for this review was performed in May 2017. We searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), BIOSIS Citation Index (Thomson Reuters Web of Science), Web of Science Core Collection, including the Science Citation Index (Thomson Reuters Web of Science) and the Conference Proceedings Citation Index (Thomson Reuters Web of Science), LILACS (BIREME), CINAHL (EBSCOhost), ClinicalTrials.gov (https://clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (http://www.who.int/ictrp/search/en/). We also searched ALOIS, the Cochrane Dementia & Cognitive Improvement Group’s specialised register of Dementia studies (http://www.medicine.ox.ac.uk/alois/). We checked the reference lists of any relevant studies and systematic reviews, and performed citation tracking using the Science Citation Index to identify any additional relevant studies. No language or date restrictions were applied to electronic searches. Selection criteria We included studies that had prospectively defined cohorts with any accepted definition of MCI at time of performing the test and the use of 18F-florbetaben scan to evaluate the DTA of the progression from MCI to ADD or other forms of Dementia. In addition, we only selected studies that applied a reference standard for Alzheimer’s Dementia diagnosis, for example, the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) or Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Data collection and analysis We screened all titles and abstracts identified in electronic-database searches. Two review authors independently selected studies for inclusion and extracted data to create two-by-two tables, showing the binary test results cross-classified with the binary reference standard. We used these data to calculate sensitivities, specificities, and their 95% confidence intervals. Two independent assessors performed quality assessment using the QUADAS-2 tool plus some additional items to assess the methodological quality of the included studies. Main results Progression from MCI to ADD, any other form of Dementia, and any form of Dementia was evaluated in one study (Ong 2015). It reported data on 45 participants at four years of follow-up; 21 participants met NINCDS-ADRDA criteria for Alzheimer’s disease Dementia at four years of follow-up, the proportion converting to ADD was 47% of the 45 participants, and 11% of the 45 participants met criteria for other types of Dementias (three cases of FrontoTemporal Dementia (FTD), one of Dementia with Lewy body (DLB), and one of Progressive Supranuclear Palsy (PSP)). We considered the study to be at high risk of bias in the domains of the reference standard, flow, and timing (QUADAS-2). MCI to ADD; 18F-florbetaben PET scan analysed visually: the sensitivity was 100% (95% confidence interval (CI) 84% to 100%) and the specificity was 83% (95% CI 63% to 98%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 100% (95% CI 84% to 100%) and the specificity was 88% (95% CI 68% to 97%) for the diagnosis of ADD at follow-up (n = 45, 1 study). MCI to any other form of Dementia (non-ADD); 18F-florbetaben PET scan analysed visually: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 38% (95% CI 23% to 54%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 40% (95% CI 25% to 57%) for the diagnosis of any other form of Dementia at follow-up (n = 45, 1 study). MCI to any form of Dementia;18F-florbetaben PET scan analysed visually: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 79% (95% CI 54% to 94%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 84% (95% CI 60% to 97%) for the diagnosis of any form of Dementia at follow-up (n = 45, 1 study). Authors' conclusions Although we were able to calculate one estimation of DTA in, especially, the prediction of progression from MCI to ADD at four years follow-up, the small number of participants implies imprecision of sensitivity and specificity estimates. We cannot make any recommendation regarding the routine use of 18F-florbetaben in clinical practice based on one single study with 45 participants. 18F-florbetaben has high financial costs, therefore, clearly demonstrating its DTA and standardising the process of the 18F-florbetaben modality are important prior to its wider use.
Gabriel Martinez - One of the best experts on this subject based on the ideXlab platform.
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18f pet with florbetaben for the early diagnosis of alzheimer s disease Dementia and other Dementias in people with mild cognitive impairment mci
Cochrane Database of Systematic Reviews, 2017Co-Authors: Gabriel Martinez, Paulina Fuentes Padilla, Xavier Bonfill Cosp, Leon Flicker, Javier Zamora, Robin W M VernooijAbstract:Background 18F-florbetaben uptake by brain tissue, measured by positron emission tomography (PET), is accepted by regulatory agencies like the Food and Drug Administration (FDA) and the European Medicine Agencies (EMA) for assessing amyloid load in people with Dementia. Its added value is mainly demonstrated by excluding Alzheimer's pathology in an established Dementia diagnosis. However, the National Institute on Aging and Alzheimer's Association (NIA-AA) revised the diagnostic criteria for Alzheimer's disease and confidence in the diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease may be increased when using some amyloid biomarkers tests like 18F-florbetaben. These tests, added to the MCI core clinical criteria, might increase the diagnostic test accuracy (DTA) of a testing strategy. However, the DTA of 18F-florbetaben to predict the progression from MCI to Alzheimer’s disease Dementia (ADD) or other Dementias has not yet been systematically evaluated. Objectives To determine the DTA of the 18F-florbetaben PET scan for detecting people with MCI at time of performing the test who will clinically progress to ADD, other forms of Dementia (non-ADD), or any form of Dementia at follow-up. Search methods The most recent search for this review was performed in May 2017. We searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), BIOSIS Citation Index (Thomson Reuters Web of Science), Web of Science Core Collection, including the Science Citation Index (Thomson Reuters Web of Science) and the Conference Proceedings Citation Index (Thomson Reuters Web of Science), LILACS (BIREME), CINAHL (EBSCOhost), ClinicalTrials.gov (https://clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (http://www.who.int/ictrp/search/en/). We also searched ALOIS, the Cochrane Dementia & Cognitive Improvement Group’s specialised register of Dementia studies (http://www.medicine.ox.ac.uk/alois/). We checked the reference lists of any relevant studies and systematic reviews, and performed citation tracking using the Science Citation Index to identify any additional relevant studies. No language or date restrictions were applied to electronic searches. Selection criteria We included studies that had prospectively defined cohorts with any accepted definition of MCI at time of performing the test and the use of 18F-florbetaben scan to evaluate the DTA of the progression from MCI to ADD or other forms of Dementia. In addition, we only selected studies that applied a reference standard for Alzheimer’s Dementia diagnosis, for example, the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) or Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Data collection and analysis We screened all titles and abstracts identified in electronic-database searches. Two review authors independently selected studies for inclusion and extracted data to create two-by-two tables, showing the binary test results cross-classified with the binary reference standard. We used these data to calculate sensitivities, specificities, and their 95% confidence intervals. Two independent assessors performed quality assessment using the QUADAS-2 tool plus some additional items to assess the methodological quality of the included studies. Main results Progression from MCI to ADD, any other form of Dementia, and any form of Dementia was evaluated in one study (Ong 2015). It reported data on 45 participants at four years of follow-up; 21 participants met NINCDS-ADRDA criteria for Alzheimer’s disease Dementia at four years of follow-up, the proportion converting to ADD was 47% of the 45 participants, and 11% of the 45 participants met criteria for other types of Dementias (three cases of FrontoTemporal Dementia (FTD), one of Dementia with Lewy body (DLB), and one of Progressive Supranuclear Palsy (PSP)). We considered the study to be at high risk of bias in the domains of the reference standard, flow, and timing (QUADAS-2). MCI to ADD; 18F-florbetaben PET scan analysed visually: the sensitivity was 100% (95% confidence interval (CI) 84% to 100%) and the specificity was 83% (95% CI 63% to 98%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 100% (95% CI 84% to 100%) and the specificity was 88% (95% CI 68% to 97%) for the diagnosis of ADD at follow-up (n = 45, 1 study). MCI to any other form of Dementia (non-ADD); 18F-florbetaben PET scan analysed visually: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 38% (95% CI 23% to 54%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 40% (95% CI 25% to 57%) for the diagnosis of any other form of Dementia at follow-up (n = 45, 1 study). MCI to any form of Dementia;18F-florbetaben PET scan analysed visually: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 79% (95% CI 54% to 94%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 84% (95% CI 60% to 97%) for the diagnosis of any form of Dementia at follow-up (n = 45, 1 study). Authors' conclusions Although we were able to calculate one estimation of DTA in, especially, the prediction of progression from MCI to ADD at four years follow-up, the small number of participants implies imprecision of sensitivity and specificity estimates. We cannot make any recommendation regarding the routine use of 18F-florbetaben in clinical practice based on one single study with 45 participants. 18F-florbetaben has high financial costs, therefore, clearly demonstrating its DTA and standardising the process of the 18F-florbetaben modality are important prior to its wider use.
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The Cochrane Library - 18F PET with florbetaben for the early diagnosis of Alzheimer's disease Dementia and other Dementias in people with mild cognitive impairment (MCI).
Cochrane Database of Systematic Reviews, 2017Co-Authors: Gabriel Martinez, Paulina Fuentes Padilla, Leon Flicker, Javier Zamora, Robin W M Vernooij, Xavier Bonfill CospAbstract:Background 18F-florbetaben uptake by brain tissue, measured by positron emission tomography (PET), is accepted by regulatory agencies like the Food and Drug Administration (FDA) and the European Medicine Agencies (EMA) for assessing amyloid load in people with Dementia. Its added value is mainly demonstrated by excluding Alzheimer's pathology in an established Dementia diagnosis. However, the National Institute on Aging and Alzheimer's Association (NIA-AA) revised the diagnostic criteria for Alzheimer's disease and confidence in the diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease may be increased when using some amyloid biomarkers tests like 18F-florbetaben. These tests, added to the MCI core clinical criteria, might increase the diagnostic test accuracy (DTA) of a testing strategy. However, the DTA of 18F-florbetaben to predict the progression from MCI to Alzheimer’s disease Dementia (ADD) or other Dementias has not yet been systematically evaluated. Objectives To determine the DTA of the 18F-florbetaben PET scan for detecting people with MCI at time of performing the test who will clinically progress to ADD, other forms of Dementia (non-ADD), or any form of Dementia at follow-up. Search methods The most recent search for this review was performed in May 2017. We searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), BIOSIS Citation Index (Thomson Reuters Web of Science), Web of Science Core Collection, including the Science Citation Index (Thomson Reuters Web of Science) and the Conference Proceedings Citation Index (Thomson Reuters Web of Science), LILACS (BIREME), CINAHL (EBSCOhost), ClinicalTrials.gov (https://clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (http://www.who.int/ictrp/search/en/). We also searched ALOIS, the Cochrane Dementia & Cognitive Improvement Group’s specialised register of Dementia studies (http://www.medicine.ox.ac.uk/alois/). We checked the reference lists of any relevant studies and systematic reviews, and performed citation tracking using the Science Citation Index to identify any additional relevant studies. No language or date restrictions were applied to electronic searches. Selection criteria We included studies that had prospectively defined cohorts with any accepted definition of MCI at time of performing the test and the use of 18F-florbetaben scan to evaluate the DTA of the progression from MCI to ADD or other forms of Dementia. In addition, we only selected studies that applied a reference standard for Alzheimer’s Dementia diagnosis, for example, the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) or Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Data collection and analysis We screened all titles and abstracts identified in electronic-database searches. Two review authors independently selected studies for inclusion and extracted data to create two-by-two tables, showing the binary test results cross-classified with the binary reference standard. We used these data to calculate sensitivities, specificities, and their 95% confidence intervals. Two independent assessors performed quality assessment using the QUADAS-2 tool plus some additional items to assess the methodological quality of the included studies. Main results Progression from MCI to ADD, any other form of Dementia, and any form of Dementia was evaluated in one study (Ong 2015). It reported data on 45 participants at four years of follow-up; 21 participants met NINCDS-ADRDA criteria for Alzheimer’s disease Dementia at four years of follow-up, the proportion converting to ADD was 47% of the 45 participants, and 11% of the 45 participants met criteria for other types of Dementias (three cases of FrontoTemporal Dementia (FTD), one of Dementia with Lewy body (DLB), and one of Progressive Supranuclear Palsy (PSP)). We considered the study to be at high risk of bias in the domains of the reference standard, flow, and timing (QUADAS-2). MCI to ADD; 18F-florbetaben PET scan analysed visually: the sensitivity was 100% (95% confidence interval (CI) 84% to 100%) and the specificity was 83% (95% CI 63% to 98%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 100% (95% CI 84% to 100%) and the specificity was 88% (95% CI 68% to 97%) for the diagnosis of ADD at follow-up (n = 45, 1 study). MCI to any other form of Dementia (non-ADD); 18F-florbetaben PET scan analysed visually: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 38% (95% CI 23% to 54%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 40% (95% CI 25% to 57%) for the diagnosis of any other form of Dementia at follow-up (n = 45, 1 study). MCI to any form of Dementia;18F-florbetaben PET scan analysed visually: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 79% (95% CI 54% to 94%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 84% (95% CI 60% to 97%) for the diagnosis of any form of Dementia at follow-up (n = 45, 1 study). Authors' conclusions Although we were able to calculate one estimation of DTA in, especially, the prediction of progression from MCI to ADD at four years follow-up, the small number of participants implies imprecision of sensitivity and specificity estimates. We cannot make any recommendation regarding the routine use of 18F-florbetaben in clinical practice based on one single study with 45 participants. 18F-florbetaben has high financial costs, therefore, clearly demonstrating its DTA and standardising the process of the 18F-florbetaben modality are important prior to its wider use.
Paulina Fuentes Padilla - One of the best experts on this subject based on the ideXlab platform.
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18f pet with florbetaben for the early diagnosis of alzheimer s disease Dementia and other Dementias in people with mild cognitive impairment mci
Cochrane Database of Systematic Reviews, 2017Co-Authors: Gabriel Martinez, Paulina Fuentes Padilla, Xavier Bonfill Cosp, Leon Flicker, Javier Zamora, Robin W M VernooijAbstract:Background 18F-florbetaben uptake by brain tissue, measured by positron emission tomography (PET), is accepted by regulatory agencies like the Food and Drug Administration (FDA) and the European Medicine Agencies (EMA) for assessing amyloid load in people with Dementia. Its added value is mainly demonstrated by excluding Alzheimer's pathology in an established Dementia diagnosis. However, the National Institute on Aging and Alzheimer's Association (NIA-AA) revised the diagnostic criteria for Alzheimer's disease and confidence in the diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease may be increased when using some amyloid biomarkers tests like 18F-florbetaben. These tests, added to the MCI core clinical criteria, might increase the diagnostic test accuracy (DTA) of a testing strategy. However, the DTA of 18F-florbetaben to predict the progression from MCI to Alzheimer’s disease Dementia (ADD) or other Dementias has not yet been systematically evaluated. Objectives To determine the DTA of the 18F-florbetaben PET scan for detecting people with MCI at time of performing the test who will clinically progress to ADD, other forms of Dementia (non-ADD), or any form of Dementia at follow-up. Search methods The most recent search for this review was performed in May 2017. We searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), BIOSIS Citation Index (Thomson Reuters Web of Science), Web of Science Core Collection, including the Science Citation Index (Thomson Reuters Web of Science) and the Conference Proceedings Citation Index (Thomson Reuters Web of Science), LILACS (BIREME), CINAHL (EBSCOhost), ClinicalTrials.gov (https://clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (http://www.who.int/ictrp/search/en/). We also searched ALOIS, the Cochrane Dementia & Cognitive Improvement Group’s specialised register of Dementia studies (http://www.medicine.ox.ac.uk/alois/). We checked the reference lists of any relevant studies and systematic reviews, and performed citation tracking using the Science Citation Index to identify any additional relevant studies. No language or date restrictions were applied to electronic searches. Selection criteria We included studies that had prospectively defined cohorts with any accepted definition of MCI at time of performing the test and the use of 18F-florbetaben scan to evaluate the DTA of the progression from MCI to ADD or other forms of Dementia. In addition, we only selected studies that applied a reference standard for Alzheimer’s Dementia diagnosis, for example, the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) or Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Data collection and analysis We screened all titles and abstracts identified in electronic-database searches. Two review authors independently selected studies for inclusion and extracted data to create two-by-two tables, showing the binary test results cross-classified with the binary reference standard. We used these data to calculate sensitivities, specificities, and their 95% confidence intervals. Two independent assessors performed quality assessment using the QUADAS-2 tool plus some additional items to assess the methodological quality of the included studies. Main results Progression from MCI to ADD, any other form of Dementia, and any form of Dementia was evaluated in one study (Ong 2015). It reported data on 45 participants at four years of follow-up; 21 participants met NINCDS-ADRDA criteria for Alzheimer’s disease Dementia at four years of follow-up, the proportion converting to ADD was 47% of the 45 participants, and 11% of the 45 participants met criteria for other types of Dementias (three cases of FrontoTemporal Dementia (FTD), one of Dementia with Lewy body (DLB), and one of Progressive Supranuclear Palsy (PSP)). We considered the study to be at high risk of bias in the domains of the reference standard, flow, and timing (QUADAS-2). MCI to ADD; 18F-florbetaben PET scan analysed visually: the sensitivity was 100% (95% confidence interval (CI) 84% to 100%) and the specificity was 83% (95% CI 63% to 98%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 100% (95% CI 84% to 100%) and the specificity was 88% (95% CI 68% to 97%) for the diagnosis of ADD at follow-up (n = 45, 1 study). MCI to any other form of Dementia (non-ADD); 18F-florbetaben PET scan analysed visually: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 38% (95% CI 23% to 54%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 40% (95% CI 25% to 57%) for the diagnosis of any other form of Dementia at follow-up (n = 45, 1 study). MCI to any form of Dementia;18F-florbetaben PET scan analysed visually: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 79% (95% CI 54% to 94%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 84% (95% CI 60% to 97%) for the diagnosis of any form of Dementia at follow-up (n = 45, 1 study). Authors' conclusions Although we were able to calculate one estimation of DTA in, especially, the prediction of progression from MCI to ADD at four years follow-up, the small number of participants implies imprecision of sensitivity and specificity estimates. We cannot make any recommendation regarding the routine use of 18F-florbetaben in clinical practice based on one single study with 45 participants. 18F-florbetaben has high financial costs, therefore, clearly demonstrating its DTA and standardising the process of the 18F-florbetaben modality are important prior to its wider use.
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The Cochrane Library - 18F PET with florbetaben for the early diagnosis of Alzheimer's disease Dementia and other Dementias in people with mild cognitive impairment (MCI).
Cochrane Database of Systematic Reviews, 2017Co-Authors: Gabriel Martinez, Paulina Fuentes Padilla, Leon Flicker, Javier Zamora, Robin W M Vernooij, Xavier Bonfill CospAbstract:Background 18F-florbetaben uptake by brain tissue, measured by positron emission tomography (PET), is accepted by regulatory agencies like the Food and Drug Administration (FDA) and the European Medicine Agencies (EMA) for assessing amyloid load in people with Dementia. Its added value is mainly demonstrated by excluding Alzheimer's pathology in an established Dementia diagnosis. However, the National Institute on Aging and Alzheimer's Association (NIA-AA) revised the diagnostic criteria for Alzheimer's disease and confidence in the diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease may be increased when using some amyloid biomarkers tests like 18F-florbetaben. These tests, added to the MCI core clinical criteria, might increase the diagnostic test accuracy (DTA) of a testing strategy. However, the DTA of 18F-florbetaben to predict the progression from MCI to Alzheimer’s disease Dementia (ADD) or other Dementias has not yet been systematically evaluated. Objectives To determine the DTA of the 18F-florbetaben PET scan for detecting people with MCI at time of performing the test who will clinically progress to ADD, other forms of Dementia (non-ADD), or any form of Dementia at follow-up. Search methods The most recent search for this review was performed in May 2017. We searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), BIOSIS Citation Index (Thomson Reuters Web of Science), Web of Science Core Collection, including the Science Citation Index (Thomson Reuters Web of Science) and the Conference Proceedings Citation Index (Thomson Reuters Web of Science), LILACS (BIREME), CINAHL (EBSCOhost), ClinicalTrials.gov (https://clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (http://www.who.int/ictrp/search/en/). We also searched ALOIS, the Cochrane Dementia & Cognitive Improvement Group’s specialised register of Dementia studies (http://www.medicine.ox.ac.uk/alois/). We checked the reference lists of any relevant studies and systematic reviews, and performed citation tracking using the Science Citation Index to identify any additional relevant studies. No language or date restrictions were applied to electronic searches. Selection criteria We included studies that had prospectively defined cohorts with any accepted definition of MCI at time of performing the test and the use of 18F-florbetaben scan to evaluate the DTA of the progression from MCI to ADD or other forms of Dementia. In addition, we only selected studies that applied a reference standard for Alzheimer’s Dementia diagnosis, for example, the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) or Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Data collection and analysis We screened all titles and abstracts identified in electronic-database searches. Two review authors independently selected studies for inclusion and extracted data to create two-by-two tables, showing the binary test results cross-classified with the binary reference standard. We used these data to calculate sensitivities, specificities, and their 95% confidence intervals. Two independent assessors performed quality assessment using the QUADAS-2 tool plus some additional items to assess the methodological quality of the included studies. Main results Progression from MCI to ADD, any other form of Dementia, and any form of Dementia was evaluated in one study (Ong 2015). It reported data on 45 participants at four years of follow-up; 21 participants met NINCDS-ADRDA criteria for Alzheimer’s disease Dementia at four years of follow-up, the proportion converting to ADD was 47% of the 45 participants, and 11% of the 45 participants met criteria for other types of Dementias (three cases of FrontoTemporal Dementia (FTD), one of Dementia with Lewy body (DLB), and one of Progressive Supranuclear Palsy (PSP)). We considered the study to be at high risk of bias in the domains of the reference standard, flow, and timing (QUADAS-2). MCI to ADD; 18F-florbetaben PET scan analysed visually: the sensitivity was 100% (95% confidence interval (CI) 84% to 100%) and the specificity was 83% (95% CI 63% to 98%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 100% (95% CI 84% to 100%) and the specificity was 88% (95% CI 68% to 97%) for the diagnosis of ADD at follow-up (n = 45, 1 study). MCI to any other form of Dementia (non-ADD); 18F-florbetaben PET scan analysed visually: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 38% (95% CI 23% to 54%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 40% (95% CI 25% to 57%) for the diagnosis of any other form of Dementia at follow-up (n = 45, 1 study). MCI to any form of Dementia;18F-florbetaben PET scan analysed visually: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 79% (95% CI 54% to 94%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 84% (95% CI 60% to 97%) for the diagnosis of any form of Dementia at follow-up (n = 45, 1 study). Authors' conclusions Although we were able to calculate one estimation of DTA in, especially, the prediction of progression from MCI to ADD at four years follow-up, the small number of participants implies imprecision of sensitivity and specificity estimates. We cannot make any recommendation regarding the routine use of 18F-florbetaben in clinical practice based on one single study with 45 participants. 18F-florbetaben has high financial costs, therefore, clearly demonstrating its DTA and standardising the process of the 18F-florbetaben modality are important prior to its wider use.
Leon Flicker - One of the best experts on this subject based on the ideXlab platform.
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18f pet with florbetaben for the early diagnosis of alzheimer s disease Dementia and other Dementias in people with mild cognitive impairment mci
Cochrane Database of Systematic Reviews, 2017Co-Authors: Gabriel Martinez, Paulina Fuentes Padilla, Xavier Bonfill Cosp, Leon Flicker, Javier Zamora, Robin W M VernooijAbstract:Background 18F-florbetaben uptake by brain tissue, measured by positron emission tomography (PET), is accepted by regulatory agencies like the Food and Drug Administration (FDA) and the European Medicine Agencies (EMA) for assessing amyloid load in people with Dementia. Its added value is mainly demonstrated by excluding Alzheimer's pathology in an established Dementia diagnosis. However, the National Institute on Aging and Alzheimer's Association (NIA-AA) revised the diagnostic criteria for Alzheimer's disease and confidence in the diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease may be increased when using some amyloid biomarkers tests like 18F-florbetaben. These tests, added to the MCI core clinical criteria, might increase the diagnostic test accuracy (DTA) of a testing strategy. However, the DTA of 18F-florbetaben to predict the progression from MCI to Alzheimer’s disease Dementia (ADD) or other Dementias has not yet been systematically evaluated. Objectives To determine the DTA of the 18F-florbetaben PET scan for detecting people with MCI at time of performing the test who will clinically progress to ADD, other forms of Dementia (non-ADD), or any form of Dementia at follow-up. Search methods The most recent search for this review was performed in May 2017. We searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), BIOSIS Citation Index (Thomson Reuters Web of Science), Web of Science Core Collection, including the Science Citation Index (Thomson Reuters Web of Science) and the Conference Proceedings Citation Index (Thomson Reuters Web of Science), LILACS (BIREME), CINAHL (EBSCOhost), ClinicalTrials.gov (https://clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (http://www.who.int/ictrp/search/en/). We also searched ALOIS, the Cochrane Dementia & Cognitive Improvement Group’s specialised register of Dementia studies (http://www.medicine.ox.ac.uk/alois/). We checked the reference lists of any relevant studies and systematic reviews, and performed citation tracking using the Science Citation Index to identify any additional relevant studies. No language or date restrictions were applied to electronic searches. Selection criteria We included studies that had prospectively defined cohorts with any accepted definition of MCI at time of performing the test and the use of 18F-florbetaben scan to evaluate the DTA of the progression from MCI to ADD or other forms of Dementia. In addition, we only selected studies that applied a reference standard for Alzheimer’s Dementia diagnosis, for example, the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) or Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Data collection and analysis We screened all titles and abstracts identified in electronic-database searches. Two review authors independently selected studies for inclusion and extracted data to create two-by-two tables, showing the binary test results cross-classified with the binary reference standard. We used these data to calculate sensitivities, specificities, and their 95% confidence intervals. Two independent assessors performed quality assessment using the QUADAS-2 tool plus some additional items to assess the methodological quality of the included studies. Main results Progression from MCI to ADD, any other form of Dementia, and any form of Dementia was evaluated in one study (Ong 2015). It reported data on 45 participants at four years of follow-up; 21 participants met NINCDS-ADRDA criteria for Alzheimer’s disease Dementia at four years of follow-up, the proportion converting to ADD was 47% of the 45 participants, and 11% of the 45 participants met criteria for other types of Dementias (three cases of FrontoTemporal Dementia (FTD), one of Dementia with Lewy body (DLB), and one of Progressive Supranuclear Palsy (PSP)). We considered the study to be at high risk of bias in the domains of the reference standard, flow, and timing (QUADAS-2). MCI to ADD; 18F-florbetaben PET scan analysed visually: the sensitivity was 100% (95% confidence interval (CI) 84% to 100%) and the specificity was 83% (95% CI 63% to 98%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 100% (95% CI 84% to 100%) and the specificity was 88% (95% CI 68% to 97%) for the diagnosis of ADD at follow-up (n = 45, 1 study). MCI to any other form of Dementia (non-ADD); 18F-florbetaben PET scan analysed visually: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 38% (95% CI 23% to 54%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 40% (95% CI 25% to 57%) for the diagnosis of any other form of Dementia at follow-up (n = 45, 1 study). MCI to any form of Dementia;18F-florbetaben PET scan analysed visually: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 79% (95% CI 54% to 94%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 84% (95% CI 60% to 97%) for the diagnosis of any form of Dementia at follow-up (n = 45, 1 study). Authors' conclusions Although we were able to calculate one estimation of DTA in, especially, the prediction of progression from MCI to ADD at four years follow-up, the small number of participants implies imprecision of sensitivity and specificity estimates. We cannot make any recommendation regarding the routine use of 18F-florbetaben in clinical practice based on one single study with 45 participants. 18F-florbetaben has high financial costs, therefore, clearly demonstrating its DTA and standardising the process of the 18F-florbetaben modality are important prior to its wider use.
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The Cochrane Library - 18F PET with florbetaben for the early diagnosis of Alzheimer's disease Dementia and other Dementias in people with mild cognitive impairment (MCI).
Cochrane Database of Systematic Reviews, 2017Co-Authors: Gabriel Martinez, Paulina Fuentes Padilla, Leon Flicker, Javier Zamora, Robin W M Vernooij, Xavier Bonfill CospAbstract:Background 18F-florbetaben uptake by brain tissue, measured by positron emission tomography (PET), is accepted by regulatory agencies like the Food and Drug Administration (FDA) and the European Medicine Agencies (EMA) for assessing amyloid load in people with Dementia. Its added value is mainly demonstrated by excluding Alzheimer's pathology in an established Dementia diagnosis. However, the National Institute on Aging and Alzheimer's Association (NIA-AA) revised the diagnostic criteria for Alzheimer's disease and confidence in the diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease may be increased when using some amyloid biomarkers tests like 18F-florbetaben. These tests, added to the MCI core clinical criteria, might increase the diagnostic test accuracy (DTA) of a testing strategy. However, the DTA of 18F-florbetaben to predict the progression from MCI to Alzheimer’s disease Dementia (ADD) or other Dementias has not yet been systematically evaluated. Objectives To determine the DTA of the 18F-florbetaben PET scan for detecting people with MCI at time of performing the test who will clinically progress to ADD, other forms of Dementia (non-ADD), or any form of Dementia at follow-up. Search methods The most recent search for this review was performed in May 2017. We searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), BIOSIS Citation Index (Thomson Reuters Web of Science), Web of Science Core Collection, including the Science Citation Index (Thomson Reuters Web of Science) and the Conference Proceedings Citation Index (Thomson Reuters Web of Science), LILACS (BIREME), CINAHL (EBSCOhost), ClinicalTrials.gov (https://clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (http://www.who.int/ictrp/search/en/). We also searched ALOIS, the Cochrane Dementia & Cognitive Improvement Group’s specialised register of Dementia studies (http://www.medicine.ox.ac.uk/alois/). We checked the reference lists of any relevant studies and systematic reviews, and performed citation tracking using the Science Citation Index to identify any additional relevant studies. No language or date restrictions were applied to electronic searches. Selection criteria We included studies that had prospectively defined cohorts with any accepted definition of MCI at time of performing the test and the use of 18F-florbetaben scan to evaluate the DTA of the progression from MCI to ADD or other forms of Dementia. In addition, we only selected studies that applied a reference standard for Alzheimer’s Dementia diagnosis, for example, the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) or Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. Data collection and analysis We screened all titles and abstracts identified in electronic-database searches. Two review authors independently selected studies for inclusion and extracted data to create two-by-two tables, showing the binary test results cross-classified with the binary reference standard. We used these data to calculate sensitivities, specificities, and their 95% confidence intervals. Two independent assessors performed quality assessment using the QUADAS-2 tool plus some additional items to assess the methodological quality of the included studies. Main results Progression from MCI to ADD, any other form of Dementia, and any form of Dementia was evaluated in one study (Ong 2015). It reported data on 45 participants at four years of follow-up; 21 participants met NINCDS-ADRDA criteria for Alzheimer’s disease Dementia at four years of follow-up, the proportion converting to ADD was 47% of the 45 participants, and 11% of the 45 participants met criteria for other types of Dementias (three cases of FrontoTemporal Dementia (FTD), one of Dementia with Lewy body (DLB), and one of Progressive Supranuclear Palsy (PSP)). We considered the study to be at high risk of bias in the domains of the reference standard, flow, and timing (QUADAS-2). MCI to ADD; 18F-florbetaben PET scan analysed visually: the sensitivity was 100% (95% confidence interval (CI) 84% to 100%) and the specificity was 83% (95% CI 63% to 98%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 100% (95% CI 84% to 100%) and the specificity was 88% (95% CI 68% to 97%) for the diagnosis of ADD at follow-up (n = 45, 1 study). MCI to any other form of Dementia (non-ADD); 18F-florbetaben PET scan analysed visually: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 38% (95% CI 23% to 54%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 0% (95% CI 0% to 52%) and the specificity was 40% (95% CI 25% to 57%) for the diagnosis of any other form of Dementia at follow-up (n = 45, 1 study). MCI to any form of Dementia;18F-florbetaben PET scan analysed visually: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 79% (95% CI 54% to 94%) (n = 45, 1 study). Analysed quantitatively: the sensitivity was 81% (95% CI 61% to 93%) and the specificity was 84% (95% CI 60% to 97%) for the diagnosis of any form of Dementia at follow-up (n = 45, 1 study). Authors' conclusions Although we were able to calculate one estimation of DTA in, especially, the prediction of progression from MCI to ADD at four years follow-up, the small number of participants implies imprecision of sensitivity and specificity estimates. We cannot make any recommendation regarding the routine use of 18F-florbetaben in clinical practice based on one single study with 45 participants. 18F-florbetaben has high financial costs, therefore, clearly demonstrating its DTA and standardising the process of the 18F-florbetaben modality are important prior to its wider use.
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A memory clinic at a geriatric hospital: rationale, routine and results from the first 100 patients.
The Medical journal of Australia, 1992Co-Authors: David Ames, Leon Flicker, Robart D HelmeAbstract:Objective To describe the operation of a memory clinic with reference to the referral pattern, patient characteristics and psychiatric diagnoses, frequency of reversible Dementias and utility of brief cognitive screening tools in the detection of Dementia. Design All patients underwent cognitive screening tests (Mini Mental Status Examination, Abbreviated Mental Test Score, Organic Brain Syndrome Scale of the Brief Assessment Scale) and two activities of daily living instruments. Psychiatric diagnoses were made according to criteria of the Diagnostic and statistical manual, third edition revised, of the American Psychiatric Association (DSM-III-R). Setting A large geriatric hospital. Subjects First 100 patients referred. Results The mean age of the patients was 75.5 years and 75 were women. Seventy-four met DSM-III-R criteria for Dementia and a further 13 had other organic brain syndromes. No case of reversible Dementia which recovered was encountered. The cognitive screening tools had a high correlation (r = 0.85-0.89) with one another but a much lower correlation with the activities of daily living instruments (r = 0.27-0.37). Conclusion Reversible Dementias are unlikely to be detected in a memory clinic at a geriatric hospital, but the assessment process may have other benefits which will need to be assessed in prospective research. The clinic population represents a unique resource for further research on Dementia.
M Brotons - One of the best experts on this subject based on the ideXlab platform.
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Music therapy for Dementia symptoms.
The Cochrane database of systematic reviews, 2000Co-Authors: S M Koger, M BrotonsAbstract:While music/music therapy does not represent a treatment of Dementia, its use is based on a possible beneficial effect on symptoms including social, emotional and cognitive skills and for decreasing behavioral problems of individuals with Dementias. Thus, there are clear implications for patients' and caregivers' quality of life. However, quantification and documentation of the evidence of this effect is necessary. Professional music therapists are accountable for providing efficient, beneficial treatment. Further, music therapists are responsible for assessing, designing and implementing music therapy treatments, monitoring client progress, and reformulating their practice according to data collected and new advancements in the field. If they wait until sufficient valid, empirical data on all aspects of a disability or music response are available before attempting to design a therapy session, they may well reach retirement age before even one client can be served. On the other hand, promulgating the efficacy of music therapy in general, or of specific music therapy techniques, in the absence of any substantiation other than intuition or tradition borders on professional recklessness. To gather and evaluate the evidence for the effectiveness of music therapy for Dementia symptoms. All available sources of references were searched for randomised controlled trials of music therapy used as an intervention in Dementia. The search terms included 'controlled trial or study, music*, therapy, dement*, Alzheimer*, cognitive impairment.' The reviewers assessed the methodological quality of the studies available for inclusion. The criteria used are presence and adequacy of a control condition, independent assessment of patients' performance (ie standardized ratings carried out by a person other than the music therapist) and the number of participants (no fewer than three). No randomised controlled trials, or trials with quantitative data suitable for analysis were found. The research into music therapy to date has lacked methodological design rigour. However, the research evidence available provides sufficient grounds on which to justify further investigations into the use of music therapy in Dementia patients. In this context, the reviewers discuss some of the issues and research from the studies that were considered for inclusion. This review was not able to identify reliable empirical evidence on which to justify the use of music therapy as a treatment for Dementia. However, the evidence available suggests that music therapy may be beneficial in treating or managing Dementia symptoms, and the predominant conclusion of this review is the highlighting of the need for better designed studies of the intervention.
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Music therapy for Dementia symptoms
The Cochrane database of systematic reviews, 2000Co-Authors: S M Koger, M BrotonsAbstract:BACKGROUND While music/music therapy does not represent a treatment of Dementia, its use is based on a possible beneficial effect on symptoms including social, emotional and cognitive skills and for decreasing behavioral problems of individuals with Dementias. Thus, there are clear implications for patients' and caregivers' quality of life. However, quantification and documentation of the evidence of this effect is necessary. Professional music therapists are accountable for providing efficient, beneficial treatment. Furthermore, music therapists are responsible for assessing, designing and implementing music therapy treatments, monitoring client progress, and reformulating their practice according to data collected and new advancements in the field. If they wait until sufficient valid, empirical data on all aspects of a disability or music response are available before attempting to design a therapy session, they may well reach retirement age before even one client can be served. On the other hand, promulgating the efficacy of music therapy in general, or of specific music therapy techniques, in the absence of any substantiation other than intuition or tradition borders on professional recklessness. OBJECTIVES To gather and evaluate the evidence for the effectiveness of music therapy for Dementia symptoms. SEARCH STRATEGY All available sources of references were searched in March 2000 for randomised controlled trials of music therapy used as an intervention in Dementia. The search terms included 'controlled trial or study, music, therapy, Dementia, Alzheimer's, cognitive impairment' and derivatives of these. SELECTION CRITERIA The reviewers assessed the methodological quality of the studies available for inclusion. The criteria used are presence and adequacy of a control condition, independent assessment of patients' performance (ie standardized ratings carried out by a person other than the music therapist) and the number of participants (no fewer than three). DATA COLLECTION AND ANALYSIS No randomised controlled trials, or trials with quantitative data suitable for analysis were found. MAIN RESULTS The research into music therapy to date has lacked methodological design rigour. However, the research evidence available provides sufficient grounds on which to justify further investigations into the use of music therapy in Dementia patients. In this context, the reviewers discuss some of the issues and research from the studies that were considered for inclusion. REVIEWER'S CONCLUSIONS This review was not able to identify reliable empirical evidence on which to justify the use of music therapy as a treatment for Dementia. However, the evidence available suggests that music therapy may be beneficial in treating or managing Dementia symptoms, and the predominant conclusion of this review is the highlighting of the need for better designed studies of the intervention.
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is music therapy an effective intervention for Dementia a meta analytic review of literature
Journal of Music Therapy, 1999Co-Authors: S M Koger, Kathryn Chapin, M BrotonsAbstract:A recent qualitative review of literature in the area of music/ music therapy and Dementias published since 1985 suggested that music/music therapy is an effective intervention for maintaining and improving active involvement, social, emotional and cognitive skills, and for decreasing behavioral problems of individuals with Dementias (Brotons, Koger, & Pickett-Cooper, 1997). The present analysis sought to update and quantify this relationship, and investigate the extent to which methodological variables influenced treatment effectiveness. Twenty-one empirical studies, with a total of 336 subjects suffering from symptoms of Dementia, were included in the meta-analysis. Overall, the effect of music/music therapy was found to be highly significant. A homogeneity analysis determined that the effect sizes were not consistent across studies; thus, a series of moderating variable analyses were conducted. We were unable to determine the source of variability between studies by analyzing type of therapeutic intervention (active or passive), music (live or taped), therapist's training (trained music therapist vs. other professional), dependent variable (behavioral, cognitive, or social), or length of treatment. Although the published literature demonstrates that music/music therapy is an effective method overall for treating symptoms of Dementia, systematic variation of treatment protocols is necessary to identify the underlying mechanisms and delineate the most effective techniques.
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Is Music Therapy an Effective Intervention for Dementia?A Meta-Analytic Review of Literature.
Journal of music therapy, 1999Co-Authors: S M Koger, Kathryn Chapin, M BrotonsAbstract:A recent qualitative review of literature in the area of music/ music therapy and Dementias published since 1985 suggested that music/music therapy is an effective intervention for maintaining and improving active involvement, social, emotional and cognitive skills, and for decreasing behavioral problems of individuals with Dementias (Brotons, Koger, & Pickett-Cooper, 1997). The present analysis sought to update and quantify this relationship, and investigate the extent to which methodological variables influenced treatment effectiveness. Twenty-one empirical studies, with a total of 336 subjects suffering from symptoms of Dementia, were included in the meta-analysis. Overall, the effect of music/music therapy was found to be highly significant. A homogeneity analysis determined that the effect sizes were not consistent across studies; thus, a series of moderating variable analyses were conducted. We were unable to determine the source of variability between studies by analyzing type of therapeutic intervention (active or passive), music (live or taped), therapist's training (trained music therapist vs. other professional), dependent variable (behavioral, cognitive, or social), or length of treatment. Although the published literature demonstrates that music/music therapy is an effective method overall for treating symptoms of Dementia, systematic variation of treatment protocols is necessary to identify the underlying mechanisms and delineate the most effective techniques.
