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Dementia specialists and early adoption of amyloid imaging.

ABSTRACT: The goal of this study was to describe the attitudes of U.S. neurologists specializing in dementia toward the use of amyloid imaging in the diagnosis of Alzheimer's disease (AD). A cross-sectional electronic physician survey of dementia specialists at U.S. medical schools was performed. The response rate for the survey was 51.9% (135/260). Greater than 83% of respondents plan to use amyloid imaging to evaluate patients for AD. Most respondents intend to use amyloid imaging as an adjunctive diagnostic modality to confirm (77%) or rule-out (73%) a diagnosis of AD; 24% plan to use amyloid imaging to screen asymptomatic individuals for evidence of cerebral amyloid. Specialists who do not intend to use amyloid imaging (16%) express concern about the cost (73%), the usefulness (55%), and likelihood of patient (55%) and clinician (59%) misinterpretation of findings. The need for patient pre-test counseling was endorsed by a large percentage (92%) of dementia specialists (higher than for genetic testing (82%)). In conclusion, dementia specialists, particularly young specialists, are likely to be early adopters of amyloid imaging. Assuming ready availability, this new technology would be used as a confirmatory test in the evaluation of AD, as well as a screening tool for asymptomatic pathology. Specialists recognize the complexity of interpreting amyloid imaging findings and the need for patient counseling before undergoing testing.

SUBMITTER: Klein EP

PROVIDER: S-EPMC3640311 | biostudies-other | 2013

REPOSITORIES: biostudies-other

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Dementia specialists and early adoption of amyloid imaging.

Klein Eran P EP Kaye Jeffrey J

Journal of Alzheimer's disease : JAD 20130101 2

The goal of this study was to describe the attitudes of U.S. neurologists specializing in dementia toward the use of amyloid imaging in the diagnosis of Alzheimer's disease (AD). A cross-sectional electronic physician survey of dementia specialists at U.S. medical schools was performed. The response rate for the survey was 51.9% (135/260). Greater than 83% of respondents plan to use amyloid imaging to evaluate patients for AD. Most respondents intend to use amyloid imaging as an adjunctive diagn ...[more]

PMID: 22976071

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Project description:PurposeAdaptive magnetic resonance imaging-guided linear accelerators (aMRI-LINACs) are an emerging technology with the potential to improve radiation treatment for cancer through improved visualization and adaptive treatment. Given the competing forces of the increased cost, knowledge, and staff required for aMRI-LINAC therapy, it is unpredictable how rapidly and for whom aMRI-LINAC therapy is being adopted. Therefore, given that aMRI-LINAC therapy was granted approval from the Food and Drug Administration in late 2017, we evaluated the National Cancer Database (NCDB) to obtain a nationwide view of early aMRI-LINAC adoption in 2018 to 2019.Methods and materialsForty-three disease sites were aggregated. A sample of patients who underwent intensity modulated radiation therapy (IMRT) from 2018 to 2019 were matched 1:1 by stage for the top 4 cancer sites. We then compared 9 characteristics of interest (age, % White [vs non-White], % residing in metro areas, % living in the greatest income quartile, % insured by Medicare, % uninsured or unknown insurance status, % treated at a comprehensive cancer center or academic center, % with no recorded Charlson-Deyo comorbidities, and % residing in an area with highest educational) between the 2 samples (aMRI-LINAC and matched IMRT).ResultsOnly 171 patients were recorded as having been treated with aMRI-LINACs in the NCDB in 2018 to 2019. Fifty-six percent were male, 89% White, and 54% enrolled in Medicare. The most common sites of disease treated were lung (33 patients), pancreas (30 patients), prostate (29 patients), and breast (23 patients). There were no significant differences between aMRI-LINAC- and IMRT-matched patients except that patients with lung or breast cancer treated with aMRI-LINAC were significantly more likely to be treated at a comprehensive cancer center or academic center.ConclusionsaMRI-LINAC adoption recorded in the NCDB after Food and Drug Administration approval was potentially underreported, slow, and attributed to academic sites of practice. Further longitudinal study will be needed to assess how practice patterns evolve with greater adoption.

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Dementia specialists and early adoption of amyloid imaging.

Publications

Dementia specialists and early adoption of amyloid imaging.

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