Session Information
Date: Wednesday, June 22, 2016
Session Title: Cognitive disorders
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To perform a systematic review of the studies on diagnostic accuracy in dementia with Lewy bodies (DLB) and to meta-analyse sensitivity, specificity and accuracy of the used diagnostic criteria, in order to evaluate how they changed over time.
Background: The identification of DLB as a distinct disease is relatively recent. Its diagnosis is based on diagnostic criteria, which were updated over the years.
Methods: We performed electronic searches of MEDLINE and SCOPUS databases to identify all relevant studies reporting diagnostic parameters regarding the clinical diagnosis of DLB until December 2015. We performed the meta-analysis on those studies that used pathological examination as gold standard, sub-classified based on the different diagnostic criteria used.
Results: We selected 21 studies on 21 populations and 1520 patients. The pooled sensitivity, specificity and accuracy were respectively 59.9%, 93% and 79.3% for criteria antecedents to those of McKeith 1996, 56.1%, 86.9% and 75.6% for McKeith criteria 1996 and 84.5%, 59.6% and 75.8% for McKeith criteria 2005. Looking at the “possible” or “probable” DLB diagnosis separately, the sensitivity, specificity and accuracy were respectively: i) 65.6%, 80.5% and 77.8% for McKeith 1996-possible in early stages of disease; ii) 66.1%, 71.5% and 68.6% for McKeith 1996-possible in late stages; iii) 19.4%, 95.1% and 77.6% for McKeith1996-probable in early stages; iv) 46.7%, 93.2% and 83.7% for McKeith 1996-probable in late stages; v) 86%, 36.7% and 69.4% for McKeith 2005-possible in late stages; vi) 83.8%, 66.9% and 77.6% for McKeith 2005-probable in late stages. No studies evaluated McKeith criteria 2005 in early stages.
Conclusions: One out five patients with DLB has a misdiagnosis. DLB diagnostic criteria have become more sensitive and less specific over time. Diagnostic accuracy did not substantially changed in the last years. Further improvement is needed to optimize the clinical diagnosis of DLB, eventually using biomarkers.
To cite this abstract in AMA style:
G. Rizzo, S. Arcuti, M. Copetti, M. Alessandria, R. Savica, A. Fontana, R. Liguori, G. Logroscino. Accuracy of clinical diagnosis of dementia with Lewy bodies: A systematic review and meta-analysis [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/accuracy-of-clinical-diagnosis-of-dementia-with-lewy-bodies-a-systematic-review-and-meta-analysis/. Accessed June 14, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/accuracy-of-clinical-diagnosis-of-dementia-with-lewy-bodies-a-systematic-review-and-meta-analysis/