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Spinal fluid proteins can help diagnose Alzheimer’s

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1 Star

Spinal fluid proteins can help diagnose Alzheimer’s

Our Review Summary

While the headline and the lead sentence emphasize the potential usefulness of spinal fluid testing for confirmation of Alzheimer’s Disease diagnoses, the story incorrectly states that the test predicted disease progression. It says the test was "able to detect 100 percent of people with memory impairments who would progress to Alzheimer’s disease within five years." But rather than predicting the future, what the researchers actually reported was that looking backwards they found that the participants who developed Alzheimer’s during the study period all had the pattern of biomarkers linked to the disease. That distinction is important, as demonstrated by the fact that less than half of the study participants who already had memory problems and had a biomarker pattern linked to Alzheimer’s actually progressed during the course of the study.

See our reviews of New York Times story and of WebMD story

 

Why This Matters

Saying that everyone who progressed from impairment to Alzheimer’s during the study period had the “disease” pattern of biomarkers is not the same as saying everyone who has the “disease” pattern will progress. The story began with a clear overstatement suggesting the test procedure can accurately diagnose Alzheimer’s. The reality is that it is less that 100% sensitive and 100% specific, the two requirements for this absolute statement.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

This story mentions neither estimates of the direct costs of such a test nor the indirect financial implications of testing before symptoms appear.

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

Not Satisfactory

Although this story does a generally careful job of highlighting the potential use of spinal fluid testing to help diagnose Alzheimer’s Disease in people who are already experiencing severe memory problems, it states that the results “predict” which patients with memory problems will develop the disease. What the researchers actually reported was that all of the patients who progressed from mild cognitive impairment to Alzheimer’s Disease during the study period had the disease-associated biomarker pattern. They did not state that having the “disease” pattern predicted progression. Indeed, while 142 participants with impairment had the “disease” pattern, only 57 (less than half) progressed from impairment to Alzheimer’s during the study.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story does not mention any potential harms of either the spinal tap procedure itself or from the interpretation of the test results. The spinal tap harms include pain and bleeding. The harms of the test could include insurance or employment discrimination, as well as the consequences of mistaken diagnoses.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

This brief story includes the key results of the study, including the percentage of study participants who had a biomarker pattern associated with Alzheimer’s Disease. However, while the story reports that the participants who had severe memory impairment at the start of the study and then developed Alzheimer’s Disease within five years all had the “disease” biomarker pattern, it does not make clear that there were also participants who had the “disease” pattern and yet did not develop Alzheimer’s during the course of the study. The failure to note the relative lack of specificity of the test methods detracts significantly from the quality of the story. 

Does the story commit disease-mongering?

Not Satisfactory

Without attribution, this story states that 26 million people worldwide have Alzheimer’s Disease. By contrast, the World Health Organization puts the global figure at 18 million people. The Alzheimer’s Association says that 5 million American’s have the disease. Some caution should be used when considering estimates by advocacy organizations. The Alzheimer’s Association estimates that the number of cases will increase by more than 50 percent over the next two decades, but it should be noted that two decades ago the group estimated the disease affected more than 4 million Americans.

 

Reference:

ALZHEIMER’S DISEASE : The Brain Killer

http://www.searo.who.int/en/Section1174/Section1199/Section1567/Section1823_8066.htm

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story does not include comments from an independent source and it fails to tell readers that several of the study authors are or were employees of the company that developed key components of the test. It also does not mention that the study was funded by an institute that receives funding from pharmaceutical companies, including the company that makes the test.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

This story does not mention that brain scans are also being tested for their ability to aid in the diagnosis of Alzheimer’s Disease.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

This story does not point out the hurdles that need to be cleared before this sort of spinal fluid test for Alzheimer’s Disease could be considered for use outside of research trials, so readers may get an unrealistic sense of how soon it might enter routine clinical use.

Does the story establish the true novelty of the approach?

Satisfactory

The story notes that this study is the latest to show that spinal fluid testing “is useful in diagnosing Alzheimer’s disease,” thus indicating it is not the first such report.

Does the story appear to rely solely or largely on a news release?

Not Applicable

Not applicable because we can’t be sure of the extent to which the story may have relied on a news release.  No quotes from an interview were included – only a quote from the journal article. 

Total Score: 1 of 9 Satisfactory

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