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Table 5 PPV and NPV for AD clinical trial and diagnostic study LM-II cutoff scores for normal cognition versus AD dementia in NACC

From: Mini Mental State Examination and Logical Memory scores for entry into Alzheimer’s disease trials

 

Sensitivity

Specificity

PPV

NPV

LM-II score (A4 Trial) (10,741 normal cognition; 6814 AD dementia)

    

Cutoff score = 6

89.0

91.1

86.4

92.9

LM-II score (BAN2401 Trial)

    

 50–64 years (2315 normal cognition; 995 AD dementia)

    

  Cutoff score = 15

99.4

27.8

37.2

99.1

 65–69 years (2092 normal cognition; 722 AD dementia)

    

  Cutoff score = 12

98.5

52.0

41.4

99.0

 70–74 years (2083 normal cognition; 1082 AD dementia)

    

  Cutoff score = 11

97.3

57.3

54.2

97.6

 75–79 years (1824 normal cognition; 1562 AD dementia)

    

  Cutoff score = 9

96.2

70.0

73.3

95.6

 80–90 years (2212 normal cognition; 2263 AD dementia)

    

  Cutoff score = 7

93.9

80.7

83.3

92.9

LM-II score (ADNI 2)

    

 16+ years of education (6583 normal cognition; 3118 AD dementia)

    

  Cutoff score = 8

92.4

90.9

82.8

96.2

 8–15 years of education (4061 normal cognition; 3518 AD dementia)

    

  Cutoff score = 4

84.4

94.6

93.1

87.5

 0–7 years of education (51 normal cognition; 143 AD dementia)

    

  Cutoff score = 2

77.8

88.2

94.9

58.4

  1. Abbreviations: NACC National Alzheimer’s Coordinating Center, MMSE Mini Mental State Examination, MCI mild cognitive impairment, LM-II Wechsler Memory Scale Logical Memory-II, ADNI 2 Alzheimer’s Disease Neuroimaging Initiative 2, PPV positive predictive value, NPV negative predictive value
  2. PPV and NPV are based on the prevalence of AD dementia in each of the age or educational categories. Cutoffs were chosen on the basis of those used in AD clinical trials and diagnostic studies: “Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Disease” (6–18 = asymptomatic AD); “A Placebo-controlled, Double-blind, Parallel-group, Bayesian Adaptive Randomization Design and Dose-Regimen-find Study to Evaluate Safety, Tolerability and Efficacy of BAN2401 in Subjects with Early Alzheimer’s Disease” (50–64 years: ≤15; 65–69 years: ≤12; 70–74 years: ≤11; 75–79 years: ≤9; 80–90 years ≤7); and ADNI 2 (16 years of education: normal ≥9; early MCI 9–11; AD ≤8; 8–15 years of education: normal ≥5; early MCI 5–9; AD ≤4; 0–7 years of education: normal ≥3; early MCI 3–6; AD ≤2)