Browsing by Subject "Diagnostic criteria"

Now showing 1 - 4 of 4
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    Application of Neuropsychological Criteria to Classify Mild Cognitive Impairment in the ACTIVE Study
    (American Psychological Association, 2020-11) Thomas, Kelsey R.; Cook, Sarah E.; Bondi, Mark W.; Unverzagt, Frederick W.; Gross, Alden L.; Willis, Sherry L.; Marsiske, Michael; Psychiatry, School of Medicine
    Objective: Comprehensive neuropsychological criteria (NP criteria) for mild cognitive impairment (MCI) has reduced diagnostic errors and better predicted progression to dementia than conventional MCI criteria that rely on a single impaired score and/or subjective report. This study aimed to implement an actuarial approach to classifying MCI in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study. Method: ACTIVE study participants (N = 2,755) were classified as cognitively normal (CN) or as having MCI using NP criteria. Estimated proportion of MCI participants and reversion rates were examined as well as baseline characteristics by MCI subtype. Mixed effect models examined associations of MCI subtype with 10-year trajectories of self-reported independence and difficulty performing instrumental activities of daily living (IADLs). Results: The proportion of MCI participants was estimated to be 18.8%. Of those with MCI at baseline, 19.2% reverted to CN status for all subsequent visits. At baseline, the multidomain-amnestic MCI group generally had the greatest breadth and depth of cognitive impairment and reported the most IADL difficulty. Longitudinally, MCI participants showed faster IADL decline than CN participants (multidomain-amnestic MCI > single domain-amnestic MCI > nonamnestic MCI). Conclusion: NP criteria identified a proportion of MCI and reversion rate within ACTIVE that is consistent with prior studies involving community-dwelling samples. The pattern of everyday functioning change suggests that being classified as MCI, particularly amnestic MCI, is predictive of future loss of independence. Future work will apply these classifications in ACTIVE to better understand the relationships between MCI and health, social, and cognitive intervention-related factors.
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    Correction to: Inflammatory breast cancer defined: proposed common diagnostic criteria to guide treatment and research
    (Springer, 2022) Jagsi, R.; Mason, G.; Overmoyer, B.A.; Woodward, W.A.; Badve, S.; Schneider, R.J.; Lang, J.E.; Alpaugh, M.; Williams, K.P.; Vaught, D.; Smith, A.; Smith, K.; Miller, K.D.; Medicine, School of Medicine
    Erratum for: Inflammatory breast cancer defined: proposed common diagnostic criteria to guide treatment and research. Jagsi R, Mason G, Overmoyer BA, Woodward WA, Badve S, Schneider RJ, Lang JE, Alpaugh M, Williams KP, Vaught D, Smith A, Smith K, Miller KD; Susan G. Komen-IBCRF IBC Collaborative in partnership with the Milburn Foundation. Breast Cancer Res Treat. 2022 Apr;192(2):235-243. doi: 10.1007/s10549-021-06434-x. Epub 2022 Jan 1. PMID: 34973083
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    Diagnostic criteria for apathy in neurocognitive disorders
    (Wiley, 2021) Miller, David S.; Robert, Philippe; Ereshefsky, Larry; Adler, Lawrence; Bateman, Daniel; Cummings, Jeff; DeKosky, Steven T.; Fischer, Corinne E.; Husain, Masud; Ismail, Zahinoor; Jaeger, Judith; Lerner, Alan J.; Li, Abby; Lyketsos, Constantine G.; Manera, Valeria; Mintzer, Jacobo; Moebius, Hans J.; Mortby, Moyra; Meulien, Didier; Pollentier, Stephane; Porsteinsson, Anton; Rasmussen, Jill; Rosenberg, Paul B.; Ruthirakuhan, Myuri T.; Sano, Mary; Zucchero Sarracini, Carla; Lanctôt, Krista L.; Psychiatry, School of Medicine
    Introduction: Apathy is common in neurocognitive disorders (NCD) but NCD-specific diagnostic criteria are needed. Methods: The International Society for CNS Clinical Trials Methodology Apathy Work Group convened an expert group and sought input from academia, health-care, industry, and regulatory bodies. A modified Delphi methodology was followed, and included an extensive literature review, two surveys, and two meetings at international conferences, culminating in a consensus meeting in 2019. Results: The final criteria reached consensus with more than 80% agreement on all parts and included: limited to people with NCD; symptoms persistent or frequently recurrent over at least 4 weeks, a change from the patient's usual behavior, and including one of the following: diminished initiative, diminished interest, or diminished emotional expression/responsiveness; causing significant functional impairment and not exclusively explained by other etiologies. Discussion: These criteria provide a framework for defining apathy as a unique clinical construct in NCD for diagnosis and further research.
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    Inflammatory breast cancer defined: proposed common diagnostic criteria to guide treatment and research
    (Springer, 2022) Jagsi, R.; Mason, G.; Overmoyer, B.A.; Woodward, W.A.; Badve, S.; Schneider, R.J.; Lang, J.E.; Alpaugh, M.; Williams, K.P.; Vaught, D.; Smith, A.; Smith, K.; Miller, K.D.; Medicine, School of Medicine
    Purpose: Inflammatory breast cancer is a deadly and aggressive type of breast cancer. A key challenge relates to the need for a more detailed, formal, objective definition of IBC, the lack of which compromises clinical care, hampers the conduct of clinical trials, and hinders the search for IBC-specific biomarkers and treatments because of the heterogeneity of patients considered to have IBC. Methods: Susan G. Komen, the Inflammatory Breast Cancer Research Foundation, and the Milburn Foundation convened patient advocates, clinicians, and researchers to review the state of IBC and to propose initiatives to advance the field. After literature review of the defining clinical, pathologic, and imaging characteristics of IBC, the experts developed a novel quantitative scoring system for diagnosis. Results: The experts identified through consensus several "defining characteristics" of IBC, including factors related to timing of onset and specific symptoms. These reflect common pathophysiologic changes, sometimes detectable on biopsy in the form of dermal lymphovascular tumor emboli and often reflected in imaging findings. Based on the importance and extent of these characteristics, the experts developed a scoring scale that yields a continuous score from 0 to 48 and proposed cut-points for categorization that can be tested in subsequent validation studies. Conclusion: To move beyond subjective 'clinical diagnosis' of IBC, we propose a quantitative scoring system to define IBC, based on clinical, pathologic, and imaging features. This system is intended to predict outcome and biology, guide treatment decisions and inclusion in clinical trials, and increase diagnostic accuracy to aid basic research; future validation studies are necessary to evaluate its performance.