Independent validation of the PrecivityAD2™ blood test to identify presence or absence of brain amyloid pathology in individuals with cognitive impairment.

NPJ dementia Pub Date : 2025-01-01 Epub Date: 2025-09-04 DOI:10.1038/s44400-025-00026-y
Justine Coppinger, Tim West, Kris M Kirmess, Ilana Fogelman, Sutapa Ray, Philip B Verghese, Joel B Braunstein, Kevin E Yarasheski
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Abstract

The diagnostic performance of the Amyloid Probability Score 2 (APS2; the algorithmic result of the PrecivityAD2™ blood test) was originally trained and validated in two cohorts of cognitively impaired (CI) individuals and is in clinical use. Here, we further test the repeatability and reliability of the prespecified APS2 algorithm and cut point in an independent cohort. APS2 diagnostic performance was determined using amyloid positron emission tomography (PET) as the reference standard. Concordance with amyloid PET was high (AUC-ROC 0.95 (95% CI): 0.93-0.98); 54% of participants had a positive APS2. The previously validated APS2 cut point yielded an overall accuracy of 91% (95% CI: 86-94%), sensitivity 90% (95% CI: 83-94%) and specificity 92% (95% CI: 84-96%). Our findings demonstrate that the prespecified APS2 algorithm and cut point are repeatable, reliable, robust, accurate, and generalizable for identifying brain beta-amyloid pathology in patients with cognitive impairment and being evaluated in a clinical care setting.

Abstract Image

Abstract Image

独立验证precvityad2™血液检测在认知障碍患者中是否存在脑淀粉样蛋白病理。
淀粉样蛋白概率评分2 (APS2, precvityad2™血液检测的算法结果)的诊断性能最初在两个认知障碍(CI)个体队列中进行了训练和验证,并已在临床使用。在此,我们在一个独立的队列中进一步测试了预先指定的APS2算法和切点的重复性和可靠性。以淀粉样正电子发射断层扫描(PET)作为参考标准,确定APS2的诊断性能。淀粉样蛋白PET的一致性较高(AUC-ROC 0.95 (95% CI): 0.93-0.98);54%的受试者APS2阳性。先前验证的APS2切点的总体准确性为91% (95% CI: 86-94%),灵敏度为90% (95% CI: 83-94%),特异性为92% (95% CI: 84-96%)。我们的研究结果表明,预先指定的APS2算法和切点可重复、可靠、稳健、准确和可推广,可用于识别认知障碍患者的脑β -淀粉样蛋白病理,并可在临床护理环境中进行评估。
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