SummaryTune into the second podcast in our series where 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.
Listen to the Other Podcasts in This Series
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.
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