Evidence map›Paper›PMID 42388698›Full record

ArticleFrontiers in neurology

Initial specialist validation of clinical decision support recommendations from a machine learning-enabled digital cognitive assessment.

Ali Jannati, Claudio Toro-Serey, Marissa Ciesla, Emma Chen, David Bates, John Showalter, Sean Tobyne, Alvaro Pascual-Leone

Abstract read
In one paragraph

Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Ali JannatiLinus Health, Inc., Boston, MA, United States.
Claudio Toro-SereyLinus Health, Inc., Boston, MA, United States.
Marissa CieslaLinus Health, Inc., Boston, MA, United States.
Emma ChenLinus Health, Inc., Boston, MA, United States.
David BatesLinus Health, Inc., Boston, MA, United States.
John ShowalterLinus Health, Inc., Boston, MA, United States.
Sean TobyneLinus Health, Inc., Boston, MA, United States.
Alvaro Pascual-LeoneLinus Health, Inc., Boston, MA, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Disease-modifying therapies for Alzheimer's disease (AD) heighten demand for scalable tools enabling primary care providers (PCPs) to detect cognitive impairment and triage patients for appropriate evaluation. The brief tablet-based Linus Health Core Cognitive Evaluation (CCE) integrates the Digital Clock and Recall (DCR) and Life and Health Questionnaire (LHQ) to generate clinical decision support (CDS) and decision-tree pathways. Methods: We conducted a retrospective specialist content-validity study (June 15-27, 2023) using a modified RAND/UCLA Appropriateness Method. Five board-certified cognitive/behavioral neurologists independently rated CDS recommendations and nine predefined pathway parts for patients aged ≥55 across 21 de-identified reports. Items scored 1-9 were summarized as pooled medians with interquartile ranges; medians ≥7 indicated appropriateness. Agreement among experts was quantified using ICC [2,k] and ICC [2,1]. Results: All cognitive-impairment recommendations met the threshold. All seven borderline/impaired-DCR pathways were appropriate (median 7-8). Two pathways fell below threshold: cognitively unimpaired individuals with Green DCR scores (median 6) and a preliminary anti-amyloid treatment referral pathway (median 5). Agreement was moderate per patient [median ICC(2,k) = 0.61] and lower for individual diagnostic-concern recommendations [median ICC(2,k) = 0.25], reflecting specialist heterogeneity on borderline non-cognitive items and ceiling effects on high-rated items. Conclusion: Cognitive neurologists judged CCE-derived CDS appropriate for PCP workup and referral decisions in older adults with suspected cognitive impairment. Findings support initial content validity of assessment-linked CDS, identify refinement priorities in low-risk and emerging-therapy pathways, and motivate planned PCP appropriateness and prospective implementation studies.

Indexed as

Alzheimer’s diseaseclinical decision supportcore cognitive evaluationdementiadigital clock and recalldigital cognitive assessmentmachine learningmild cognitive impairment

Identifiers

PMID42388698
PMCPMC13318572

What Socratic holds

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Registered trials

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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.