Evidence map›Paper›PMID 33780367›Full record

ArticleJournal of Alzheimer's disease : JAD2021

Screening for Early-Stage Alzheimer's Disease Using Optimized Feature Sets and Machine Learning.

Michael J Kleiman, Elan Barenholtz, James E Galvin, Alzheimer’s Disease Neuroimaging Initiative

Abstract read
In one paragraph

Article in Journal of Alzheimer's disease : JAD, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Identifying dementia neuropathology using low-burden clinical data.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Article
  5. Article
  6. Article
  7. Article
  8. Research on Alzheimer's Disease (AD) Involving the Use ofCentral nervous system agents in medicinal chemistry · 2025
    Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
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  17. Article
  18. Alzheimer's Disease Assessments Optimized for Diagnostic Accuracy and Administration Time.IEEE journal of translational engineering in health and medicine · 2022
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Michael J KleimanComprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
Elan BarenholtzCenter for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, FL, USA.
James E GalvinComprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
Alzheimer’s Disease Neuroimaging Initiative

Funding

Alzheimer's Disease Neuroimaging Initiative - SupplementU01AG024904 · NIA · NORTHERN CALIFORNIA INSTITUTE RES &EDUC · PI WEINER, MICHAEL W · 2004 to 2015
$121.0M
Multicultural Community Dementia ScreeningR01AG071514 · NIA · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI GALVIN, JAMES E · 2021 to 2025
$13.8M
Reducing Disparities in Dementia and VCID Outcomes in a Multicultural Rural PopulationR01NS101483 · NINDS · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI GALVIN, JAMES E · 2019 to 2023
$8.0M
Digital Detection of Dementia Studies (D cubed Studies).R01AG069765 · NIA · INDIANA UNIVERSITY INDIANAPOLIS · PI BEN-MILED, ZINA, BOUSTANI, MALAZ · 2020 to 2024
$4.9M
Multicultural Community Dementia Screening.R01AG040211 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI GALVIN, JAMES E · 2011 to 2018
$3.2M
NIA NIH HHS R01 AG040211NIA NIH HHS R01 AG069765NIA NIH HHS R01 AG071514NIA NIH HHS U01 AG024904NINDS NIH HHS R01 NS101483
6 · The paper itself

Abstract

backgroundDetecting early-stage Alzheimer's disease in clinical practice is difficult due to a lack of efficient and easily administered cognitive assessments that are sensitive to very mild impairment, a likely contributor to the high rate of undetected dementia.

objectiveWe aim to identify groups of cognitive assessment features optimized for detecting mild impairment that may be used to improve routine screening. We also compare the efficacy of classifying impairment using either a two-class (impaired versus non-impaired) or three-class using the Clinical Dementia Rating (CDR 0 versus CDR 0.5 versus CDR 1) approach.

methodsSupervised feature selection methods generated groups of cognitive measurements targeting impairment defined at CDR 0.5 and above. Random forest classifiers then generated predictions of impairment for each group using highly stochastic cross-validation, with group outputs examined using general linear models.

resultsThe strategy of combining impairment levels for two-class classification resulted in significantly higher sensitivities and negative predictive values, two metrics useful in clinical screening, compared to the three-class approach. Four features (delayed WAIS Logical Memory, trail-making, patient and informant memory questions), totaling about 15 minutes of testing time (∼30 minutes with delay), enabled classification sensitivity of 94.53% (88.43% positive predictive value, PPV). The addition of four more features significantly increased sensitivity to 95.18% (88.77% PPV) when added to the model as a second classifier.

conclusionThe high detection rate paired with the minimal assessment time of the four identified features may act as an effective starting point for developing screening protocols targeting cognitive impairment defined at CDR 0.5 and above.

Indexed as

Machine LearningAgedAged, 80 and overAlzheimer DiseaseCognitive DysfunctionDisease ProgressionFemaleHumansMaleMass ScreeningMental Status and Dementia TestsMiddle AgedNeuropsychological TestsSensitivity and SpecificityAlzheimer’s diseasedata miningmild cognitive impairmentneuropsychological testssupervised machine learning

Identifiers

PMID33780367
PMCPMC8324324

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.