To evaluate the impact of kidney dysfunction and anemia on plasma phosphorylated tau 217 levels and establish subgroup-specific cutoffs for improved diagnostic accuracy, emphasizing the need for adjusted thresholds.
Key Findings:
Subgroup-specific cutoffs improved diagnostic accuracy in chronic kidney disease from 0.65 to 0.83, indicating significant clinical relevance.
Accuracy in patients with anemia increased from 0.80 to 0.86, demonstrating the importance of tailored cutoffs.
The double-cutoff strategy reduced false classifications but resulted in 39% intermediate results requiring confirmatory imaging, highlighting a trade-off.
Interpretation:
Kidney dysfunction and anemia significantly elevate plasma p-tau217 levels, necessitating adjusted diagnostic thresholds to maintain accuracy for amyloid positivity.
Limitations:
Cohort limited to East Asian participants, affecting generalizability to diverse populations.
Not all comorbidities influencing plasma p-tau217 levels were assessed, potentially impacting results.
Cost-effectiveness estimates based on modeled assumptions may vary across healthcare systems, affecting applicability.
Conclusion:
Biologically informed plasma p-tau217 cutoffs enhance diagnostic precision, particularly in chronic kidney disease and anemia, while a double-cutoff approach is more effective in obesity.
