There have been a number of studies on the impact of Alzheimer Amyloid PET scan testing, on patient outcomes like changes in treatment plan or changes in diagnosis. Have their been studies of amyloid PET scans in cognitive disorders that show ECONOMIC changes like health economics or cost per qaly, etc.
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Amyloid PET scans have significantly impacted the field of neurodegenerative disorders, particularly in the diagnosis and management of Alzheimer's disease. These scans are crucial for detecting amyloid plaques, a key feature of Alzheimer's disease (Iaccarino et al., 2022). Research has shown a positive correlation between knowledge of amyloid status obtained through PET scans and changes in patient management, including the addition of Alzheimer's disease medication (Pletnikova, 2023). Studies have highlighted the substantial role of amyloid PET scans in influencing treatment decisions and improving diagnostic accuracy in dementia (James et al., 2020). The Imaging Dementia Evidence for Amyloid Scanning (IDEAS) study has emphasized the diagnostic and management benefits of amyloid PET scans in Alzheimer's disease and related dementias (Jutkowitz, 2023).
Moreover, amyloid PET scans provide incremental diagnostic value in patients with cognitive impairment, significantly impacting diagnostic confidence, drug treatment, and overall diagnosis (Boccardi et al., 2016). The IDEAS trial, supported by the Centers for Medicare and Medicaid Services, has enrolled a large number of Medicare beneficiaries to assess changes in diagnosis and treatment resulting from amyloid PET scans (Salloway, 2018). Specific tracer studies have demonstrated the substantial clinical impact of amyloid PET scans on both Alzheimer's disease and non-Alzheimer's disease diagnoses, enhancing diagnostic confidence and influencing patient management decisions (Okita et al., 2022).
Additionally, the routine clinical application of amyloid PET imaging has improved the evaluation of patients with cognitive impairment (Bélanger et al., 2022). While these scans help individuals and caregivers better understand the diagnosis, concerns exist regarding potential psychological harm from scan results (Hattori et al., 2020). The use of amyloid PET scans as a diagnostic tool positively influences the willingness of individuals with cognitive impairment to undergo risky treatments to improve cognition (Couch et al., 2023).
Furthermore, amyloid PET scans have been explored in various cognitive disorders beyond Alzheimer's disease, such as Parkinson's disease dementia, aiding physicians in assessing patients with specific cognitive and behavioral features (Na et al., 2020). Studies have also examined the psychosocial and behavioral outcomes for individuals with cognitive impairment and their caregivers following the disclosure of amyloid PET scan results, underscoring the importance of understanding the implications of such diagnostic information (Lingler et al., 2018). Research has delved into the experiences of individuals with amnestic mild cognitive impairment post-disclosure of amyloid PET results, shedding light on the emotional and cognitive impact of such information (Jutkowitz et al., 2019).
In terms of economic considerations, while the clinical benefits and diagnostic value of amyloid PET scans are well-documented, there is a research gap regarding the direct economic impact of these scans in cognitive disorders. Existing literature primarily focuses on the clinical utility, diagnostic accuracy, and management implications of amyloid PET scans, with limited emphasis on their economic implications.
In conclusion, amyloid PET scans have significantly influenced the diagnosis, management, and treatment decisions in cognitive disorders, particularly Alzheimer's disease. While the clinical impact and diagnostic value of these scans have been extensively studied, there is a notable gap in research regarding the economic changes resulting from the integration of amyloid PET scans in the assessment of cognitive disorders. Future research should aim to address this gap to provide a comprehensive understanding of the holistic impact of amyloid PET imaging in both clinical and economic contexts.
References:
Boccardi, M., Altomare, D., Ferrari, C., Festari, C., Guerra, U., Paghera, B., … & Frisoni, G. (2016). Assessment of the incremental diagnostic value of florbetapir f 18 imaging in patients with cognitive impairment. Jama Neurology, 73(12), 1417. https://doi.org/10.1001/jamaneurol.2016.3751
Bélanger, E., Couch, E., Carroll, M., DePasquale, N., Gadbois, E., Shepherd‐Banigan, M., … & Wetle, T. (2022). Advance directives among cognitively impaired persons who had an amyloid pet scan and their care partners: a mixed-methods study. BMC Palliative Care, 21(1). https://doi.org/10.1186/s12904-022-01082-4
Couch, E., Ashford, M., Zhang, W., & Prina, M. (2023). Psychosocial and behavioral outcomes for persons with cognitive impairment and caregivers following amyloid-β pet scan disclosure. Alzheimer Disease & Associated Disorders, 37(3), 246-258. https://doi.org/10.1097/wad.0000000000000569
Hattori, N., Sherwin, P., & Farrar, G. (2020). Initial physician experience with [18f]flutemetamol amyloid pet imaging following availability for routine clinical use in japan. Journal of Alzheimer S Disease Reports, 4(1), 165-174. https://doi.org/10.3233/adr-190150
Iaccarino, L., Soleimani‐Meigooni, D., & Rabinovici, G. (2022). The role of amyloid pet in imaging neurodegenerative disorders: a review. Journal of Nuclear Medicine, 63(Supplement 1), 13S-19S. https://doi.org/10.2967/jnumed.121.263195
James, H., Houtven, C., Lippmann, S., Burke, J., Shepherd‐Banigan, M., Bélanger, E., … & Plassman, B. (2020). How accurately do patients and their care partners report results of amyloid-β pet scans for alzheimer’s disease assessment?. Journal of Alzheimer S Disease, 74(2), 625-636. https://doi.org/10.3233/jad-190922
Jutkowitz, E. (2023). Association between results of an amyloid pet scan and healthcare utilization in individuals with cognitive impairment. Journal of the American Geriatrics Society, 72(3), 707-717. https://doi.org/10.1111/jgs.18696
Jutkowitz, E., Houtven, C., Plassman, B., & Mor, V. (2019). Willingness to undergo a risky treatment to improve cognition among persons with cognitive impairment who received an amyloid pet scan. Alzheimer Disease & Associated Disorders, 34(1), 1-9. https://doi.org/10.1097/wad.0000000000000338
Lingler, J., Roberts, J., Kim, H., Morris, J., Hu, L., Mattos, M., … & López, O. (2018). Amyloid positron emission tomography candidates may focus more on benefits than risks of results disclosure. Alzheimer S & Dementia Diagnosis Assessment & Disease Monitoring, 10(1), 413-420. https://doi.org/10.1016/j.dadm.2018.05.003
Na, S., Jeong, H., Park, J., Chung, Y., & Song, I. (2020). The impact of amyloid-beta positivity with 18f-florbetaben pet on neuropsychological aspects in parkinson’s disease dementia. Metabolites, 10(10), 380. https://doi.org/10.3390/metabo10100380
Okita, K., Motoi, Y., Mizuno, T., Ikeda, M., Sanjo, N., Murakami, K., … & Sato, N. (2022). Clinical impact of amyloid pet using 18f-florbetapir in patients with cognitive impairment and suspected alzheimer’s disease: a multicenter study. Annals of Nuclear Medicine, 36(12), 1039-1049. https://doi.org/10.1007/s12149-022-01792-y
Pletnikova, A. (2023). Utility of amyloid pet imaging in a memory clinic. Alzheimer Disease & Associated Disorders, 37(4), 270-273. https://doi.org/10.1097/wad.0000000000000575
Salloway, S. (2018). Improving evaluation of patients with cognitive impairment with amyloid positron emission tomography. Jama Neurology, 75(9), 1045. https://doi.org/10.1001/jamaneurol.2018.1010
