E2 – CSF Clinical Diagnosis’ Used to Inform Guidance on Detecting Alzheimer’s Disease

Summary

Dr. Leslie Shaw, Professor of Pathology and Laboratory Medicine at the Pearlman School of Medicine at the University of Pennsylvania and Chair of the Workgroup that developed the Alzheimer’s Association’s appropriate use criteria for lumbar puncture and cerebral spinal fluid (CSF) testing in the diagnosis of Alzheimer’s disease, discusses how the Workgroup reviewed an extensive body of research on advances in CSF testing to develop the AUC.

Please note: This is an archived post. Some of the information and data discussed in this article may be out of date. It is preserved here for historical reference but should not be used as the basis for business decisions. Please see our main Insights section for more recent posts.

“The workgroup team developed the AUC guidance document for the safe collection of CSF by lumbar puncture and the use of these tests in CSF for the accurate detection of AD pathology in individual patients for whom the clinician determines the testing is appropriate.” Dr. Leslie Shaw

Panelists

Guest Speaker

Dr. Leslie Shaw , Professor of Pathology and Laboratory Medicine , University of Pennsylvania

This interview was originally published as a podcast. The audio is no longer available, but you can read the transcript below. For updates on our newly released content, visit our Insight Subscription page.

Explore Other Interviews in This Series

E1 – New Appropriate Use Criteria in Diagnosing Alzheimer’s Disease
E3 – New Appropriate Use Criteria Increases Likelihood of Accurate Diagnosis for Alzheimer’s Disease

Transcription:

Dr. Leslie Shaw: Welcome to the second of three podcasts to accompany the release of the new appropriate use criteria (AUC) for cerebral spinal fluid (CSF) testing for the diagnosis of Alzheimer’s disease developed by an expert workgroup convened by the Alzheimer’s Association and with technical support from Avalere Health. My name is Dr. Leslie Shaw and I’m professor of Pathology and Laboratory Medicine at the Pearlman School of Medicine at the University of Pennsylvania.

In this session, I want to focus on the difference between the use of CSF testing in research versus in clinical practice. This is an important distinction to understanding the value of CSF in diagnosis and the purpose of this guidance document.

An abundance of research studies done in more than 15,000 patients with a clinical diagnosis of Alzheimer’s disease and 13,000 control individuals inform us that CSF testing for amyloid, beta, and tau proteins reliably detects the hallmarks of Alzheimer’s disease pathology, namely, amyloid plaques and neurofibrillary tangles in AD patients and in patients at the earlier pre-dementia stage of the disease. There have been improvements in the overall reliability of the methods measuring these in CSF with a high degree of sensitivity and specificity. Using this extensive body of work as a basis, the workgroup team developed the AUC guidance document for the safe collection of CSF by lumbar puncture and the use of these tests in CSF for the accurate detection of AD pathology in individual patients for whom the clinician determines the testing is appropriate.

This is an important step since these tests have been used mainly in the context of research studies in patient cohorts here in the United States. Thus, this AUC provides information and guidance to enable the coupling of these objective measures of disease presence or absence to the clinical findings making more accurate diagnosis possible in the individual patient.