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NIH recap on ‘brain disease test’: strong on study results, but lacks clarity on patient benefits

NIH scientists adapt new brain disease test for Parkinson’s, dementia with Lewy bodies

Our Review Summary

brain test

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This news release describes how researchers are adapting a test they developed for rapid diagnosis of prion diseases to earlier detection of Parkinson’s disease and dementia with Lewy bodies. The news release gives data from the results, which appeared in a published study, and explains how a more rapid test could help identify patients for clinical trials. However, it doesn’t talk about the impact of early detection of these devastating diseases on patients or give a good sense of the test’s potential availability. Also, it doesn’t mention that four of the authors have applied for a patent on the related technology.

 

Why This Matters

Quicker, cheaper detection of neurological diseases might be good for individual patients, or it might not. News releases about such advances will be read by patients and their families and should strive to discuss the impact of early diagnosis, beyond the potential benefits for research. That might include prompter treatment of symptoms or unnecessary anxiety, for example.

Readers should be aware that since the test is still under development; earlier detection from such a test isn’t going to be available to individual patients any time soon.

Criteria

Does the news release adequately discuss the costs of the intervention?

Not Satisfactory

There’s no mention of the cost. The study itself says having quicker results “markedly enhances the cost effectiveness and practicality” of these tests.

Does the news release adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The release says the test “correctly excluded all the 31 controls and diagnosed both Parkinson’s disease and dementia with Lewy bodies with 93 percent accuracy.” The author also noted the number of people tested.

Does the news release adequately explain/quantify the harms of the intervention?

Not Satisfactory

There’s no discussion of how patients might be affected by earlier diagnosis. For example, do patients want to know whether they have one of these incurable diseases?

According to the study, “the earlier the diagnosis, the earlier that any appropriately targeted therapies can be initiated before further tissue damage is done.” But the news release doesn’t explore that potential benefit.

Also, a 93 percent accuracy rate means 7 percent of patients will get a false result. According to the study, the test correctly identified those without the disease in all cases, which means the disease was not detected in some patients, which could give them a false assurance.

The release doesn’t assess potential harms of taking spinal fluid samples, which though generally considered safe it is still an invasive test and can result in headache, back pain, bleeding, and increased skull pressure. The release states that researchers are attempting to come up with better tests for neurological diseases “using the least invasive patient sample possible — whether that is blood, skin, nasal brushings, or other samples.”

Does the news release seem to grasp the quality of the evidence?

Satisfactory

The release gives specific information on the scope of the study, including that researchers “tested 60 cerebral spinal fluid samples, including 12 from people with Parkinson’s disease, 17 from people with dementia with Lewy bodies, and 31 controls, including 16 of whom had Alzheimer’s disease.”

However, it doesn’t mention some limitations, such as very small number of patient volunteers and the researchers’ observations that factors such as sample volume and temperature “strongly influenced the performance of the assay.”  The researchers say further testing will be necessary to understand some of the specific detection abilities of the test, including when they’re used in clinical settings.

If the test is to be used in clinical trials, standardization across sites will have to be assured — both where samples are collected and where the assay is done.

Does the news release commit disease-mongering?

Satisfactory

There’s no evidence of disease-mongering. The release says Parkinson’s disease affects “up to 1 million people in the United States, with 60,000 new cases diagnosed each year. Lewy body dementia affects an estimated 1.4 million people in the United States, according to the Lewy Body Dementia Association.”

Does the news release identify funding sources & disclose conflicts of interest?

Not Satisfactory

The news release mentions that the research was supported by the NIH but doesn’t mention other significant funders such as the Parkinson’s and Movement Disorder Foundation and the Shiley-Marcos Alzheimer’s Disease Research Center at the University of California San Diego.

It also doesn’t note (as the published article does) that four study authors have applied for a US provisional patent application on the technology.

Does the news release compare the new approach with existing alternatives?

Satisfactory

The news release says “test results were available within two days, compared to related assays that require up to 13 days.”

However, it doesn’t say how the faster test compares in terms of accuracy. The study says early detection is helpful in part because “the accuracy of diagnoses based on other clinical indices is poorest in the earlier phases of disease.”

Does the news release establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The tentative wording of the lead — that the test could “offer the possibility of improving early diagnosis” — raises the question of what needs to happen for this test to become widely available. The release doesn’t answer that question.

Nor does the study discuss improved diagnosis since that’s not the intent of the test’s development — it’s research to determine who to include in trials and follow their disease progression.

Does the news release establish the true novelty of the approach?

Satisfactory

The release does a good job here, stating:

Early and accurate diagnoses of these brain disorders is essential for developing treatments and identifying patients eligible for clinical trials. The diseases typically progress for years before symptoms appear, and once they do, distinguishing one disease from another can be difficult.

Total Score: 6 of 10 Satisfactory

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