Long-term Clinical utility of amyloid-PET in an unselected memory clinic cohort
Project aim: ABIDE-clinical utility aims to investigate clinical utility (health benefits in terms of quality of life, care trajectories, life style modification, cognitive status, institutionalisation) of amyloid-PET using a big-data approach, leveraging on existing data where possible and adding novel data on quality of life.
Background: The advances in diagnosis of Alzheimer’s disease (AD) are among the largest successes of AD research. Innovative methods such as amyloid-PET can further improve diagnostic care but are not yet part of routine practice. IS has been shown that amyloid-PET has diagnostic value. Clinical utility for long term patient management has not yet been established however, as it is unclear how amyloid-PET infers health benefits downstream in the disease process.
Approach: As part of the ZonMW-Memorabel project ABIDE, the consortium partners offered [18F]florbetaben (FBB) PET to all patients visiting our memory clinic in 2015/2016. During this period, roughly 450 patients underwent FBB PET and 450 did not. In the current three year project, the partners take this ‘natural experiment’ as a starting point to study differences in care trajectories in relation to amyloid PET.
To achieve this goal, they will use a big data approach, linking data from different sources to obtain dense information on disease trajectories and care costs. They will contact all patients to assess current cognitive status, quality of life, use of cholinesterase inhibitors, use of health care facilities, caregiver burden and lifestyle. Moreover, they will link to existing registries, including GP-registrations, hospital registration, health insurance registration and CBS. They will perform a stratified analyses, to identify in which patients amyloid PET yields health benefits.
Deliverables: With these data the project will deliver recommendations for implementation of amyloid PET in clinical practice, including effective integration of amyloid PET in care pathways and reimbursement packages.