Home › Research › What the research found › Every row
Every row of the evidence table
One row per finding: what was tested, which way the result went, and how the study was built. The answer by area, and where the studies disagree, are on the main page.
Every row
Filter
Showing 15 of 382 rows. One row per study per exposure: a study that tested two different things appears twice, once for each.
Scroll the table sideways to see every column.
| Exposure | Question | Direction | Outcome measured | Design | People | Effect size, as the source reported it | Source |
|---|---|---|---|---|---|---|---|
| Blood biomarker test (p-tau217 / amyloid ratio) Care, carers and services | Treatment |
Benefit
whyDirection is for the test's accuracy against the reference standard; an accuracy result, not a health outcome. Among p-tau217-positive patients, a positive eMTBR-tau243 identified clinically established Alzheimer's disease with 81% accuracy and predicted faster cognitive decline and tau accumulation. |
Classification of established Alzheimer's disease by plasma eMTBR-tau243 among %p-tau217-positive patients | cohort study | 572 | 194 (55%) of 350 %p-tau217-positive patients were also positive for eMTBR-tau243, with an accuracy of 81% (95% CI 76-84), PPV 84% (95% CI 78-88), negative predictive value (NPV) 77% (95% CI 68-82), and sensitivity 82% (95% CI 76-87) for established Alzheimer's disease, in cross-sectional analyses |
The Lancet. Neurology
2026 ✓ Peer-reviewed PMID 41864233 |
| Blood biomarker test (p-tau217 / amyloid ratio) Care, carers and services | Treatment |
Benefit
whyDirection is for the test's accuracy against the reference standard; an accuracy result, not a health outcome. All p-tau217 tests detected abnormal amyloid PET (AUC 0.91-0.96) and tau PET (0.94-0.97); the mass-spectrometry %p-tau217 ratio was best (accuracy 0.93 versus 0.83-0.88 for immunoassays) and is proposed as a stand-alone confirmatory test, with immunoassays better suited to triage. |
Accuracy of five plasma p-tau217 tests for amyloid PET and tau PET status, benchmarked against CSF tests | cohort study | 998 | All plasma p-tau217 tests exhibited a high ability to detect abnormal Aβ-PET [area under the curve (AUC) range: 0.91-0.96] and tau-PET (AUC range: 0.94-0.97) ... For detecting Aβ-PET status, %p-tau217WashU had an accuracy of 0.93 (immunoassays: 0.83-0.88), sensitivity of 0.91 (immunoassays: 0.84-0.87) and a specificity of 0.94 (immunoassays: 0.85-0.89) |
Brain
2025 ✓ Peer-reviewed PMID 39468767 |
| Blood biomarker test (p-tau217 / amyloid ratio) Care, carers and services | Treatment |
Benefit
whyDirection is for the test's accuracy against the reference standard; an accuracy result, not a health outcome. The ALZpath plasma p-tau217 immunoassay reached AUC 0.92-0.96 for amyloid and 0.93-0.97 for tau across three cohorts, comparable with CSF, and a three-range cut-off cut confirmatory testing by about 80%. |
Accuracy for abnormal amyloid and tau pathology (PET or CSF) and longitudinal change | cohort study | 786 | High accuracy was observed in identifying elevated Aβ (area under the curve [AUC], 0.92-0.96; 95% CI, 0.89-0.99) and tau pathology (AUC, 0.93-0.97; 95% CI, 0.84-0.99) across all cohorts. These accuracies were comparable with CSF biomarkers in determining abnormal PET signal. The detection of abnormal Aβ pathology using a 3-range reference yielded reproducible results and reduced confirmatory testing by approximately 80% |
JAMA Neurology
2024 ✓ Peer-reviewed PMID 38252443 |
| Blood biomarker test (p-tau217 / amyloid ratio) Care, carers and services | Treatment |
Benefit
whyDirection is for the test's accuracy against the reference standard; an accuracy result, not a health outcome. Plasma p-tau217 identified amyloid positivity with AUC 0.94; a two-cut-point rule sent only 17% for CSF or PET (sensitivity 0.94, specificity 0.86), and among amyloid-positive people it identified high tau load (AUC 0.92), potentially avoiding 56.9% of tau-PET scans. |
Identification of amyloid positivity and of high tau-PET load (to select candidates for anti-amyloid antibodies) | cohort study | 912 | plasma p-tau217 was most strongly associated with Aβ positivity (test-set area under the receiver operating characteristic curve [AUC] = 0.94; 95% CI, 0.90-0.97) ... This procedure had an overall sensitivity of 0.94 (95% CI, 0.90-0.98) and a specificity of 0.86 (95% CI, 0.77-0.95) ... At a false-negative rate less than 10%, the use of plasma p-tau217 could avoid 56.9% of tau-PET scans needed to identify high tau PET among Aβ-positive participants |
JAMA Neurology
2024 ✓ Peer-reviewed PMID 38048096 |
| Blood biomarker test (p-tau217 / amyloid ratio) Care, carers and services | Treatment |
Benefit
whyDirection is for the test's accuracy against the reference standard; an accuracy result, not a health outcome. A blood model of p-tau217, age and APOE ε4 (AUC 89.3% development, 94.3% validation) used to triage patients gave 88-92% overall accuracy while cutting confirmatory CSF tests by 61-86%. |
Accuracy for amyloid PET status and reduction in confirmatory CSF tests with a two-step plasma p-tau217 workflow | cohort study | 348 | Depending on whether lenient, moderate or stringent thresholds were used in step 1, the two-step workflow overall accuracy for detecting Aβ-PET status was 88.2%, 90.5% and 92.0%, respectively, while reducing the number of necessary CSF tests by 85.9%, 72.7% and 61.2%, respectively |
Nature Aging
2023 ✓ Peer-reviewed PMID 37653254 |
| Blood biomarkers (GFAP, NfL, p-tau181) for staging and prognosis Care, carers and services | Treatment |
Benefit
whyDirection is for disclosing the blood panel during multidisciplinary meetings: median diagnostic confidence rose from 80% to 90%, though the suspected etiology changed in only 5% of patients and the syndrome diagnosis in 1%. Against CSF/PET, high- and low-probability results identified 76% of amyloid positives and 85% of negatives. |
Change in clinician diagnostic confidence and in syndrome or etiological diagnosis after disclosure of a plasma biomarker panel (p-tau181, GFAP, NfL) | cohort study | 450 | Median (IQR) diagnostic confidence in the total cohort increased from 80% (70%-90%) to 90% (70%-90%) after BBM disclosure (P < .001), increasing in 207 patients (46%), unchanged in 175 patients (39%), and decreasing in 68 patients (15%). Following BBM disclosure, syndrome diagnoses were revised in 6 patients (1%) and primary etiology was revealed in 23 patients (5%) |
JAMA Network Open
2026 ✓ Peer-reviewed PMID 42593792 |
| Blood biomarkers (GFAP, NfL, p-tau217) for staging and prognosis Care, carers and services | Treatment |
Benefit
whyDirection is for the test's accuracy against the reference standard; an accuracy result, not a health outcome. The two-marker plasma model matched PET-based stages with a C index of 0.91 in both the derivation and validation cohorts, tracked clinical stage (C index 0.84-0.86) and aligned with autopsy ADNC (AUC 0.96), improving on %p-tau217 alone at the intermediate stage. |
Concordance of a plasma %p-tau217 plus eMTBR-tau243 staging model with amyloid/tau PET-based biological stages, clinical stage and autopsy-confirmed AD pathology | cohort study | 1,028 | A plasma-based model with %p-tau217 and eMTBR-tau243 was derived, which demonstrated high concordance with established PET-based stages (C index, 0.91; 95% CI, 0.90-0.92) and was associated with clinical stage within the AD continuum (C index, 0.84; 95% CI, 0.82-0.86). In the validation cohort, concordance with PET-based stages was high (C index, 0.91; 95% CI, 0.87-0.94), as was concordance with clinical stage (C index, 0.86; 95% CI, 0.82-0.89) ... In the neuropathology subsample, plasma staging was strongly aligned with autopsy-confirmed AD pathology using the Alzheimer Disease Neuropathologic Change scale (area under the curve, 0.96; 95% CI, 0.91-1.00) |
JAMA Neurology
2026 ✓ Peer-reviewed PMID 42189519 |
| Blood biomarkers (GFAP, NfL, p-tau217) for staging and prognosis Care, carers and services | Treatment |
Benefit
whyDirection is for the test's accuracy against the reference standard; an accuracy result, not a health outcome. Serum GFAP tracked post-mortem tau pathology independently of amyloid, correlated negatively with brain weight and cognition, correlated with astrocyte reactivity in tissue, and separated neuropathologically confirmed AD from non-AD dementias with AUC 0.91. |
Correlation of serum GFAP with post-mortem tau pathology, brain weight and astrocyte reactivity, and discrimination of autopsy-confirmed AD from non-AD dementia | cohort study | 139 | an association between serum GFAP level and post-mortem tau pathology (β = 12.85; P < 0.001) that was independent of amyloid deposits (β = 13.23; P = 0.02) ... a negative correlation was observed between pre-mortem serum GFAP and brain weight at post-mortem (r = -0.35; P < 0.001) ... its discriminative power (area under the receiver operator characteristic curve at baseline = 0.91) in differentiating neuropathologically-confirmed Alzheimer's disease dementias from non-Alzheimer's disease dementias |
Brain
2024 ✓ Peer-reviewed PMID 38634687 |
| CSF alpha-synuclein seed amplification assay Care, carers and services | Treatment |
Benefit
whyDirection is for the test's accuracy against the reference standard; an accuracy result, not a health outcome. Smell testing followed by CSF seed amplification only in those with reduced smell predicted brain Lewy body pathology with 94% accuracy and cut CSF testing by 43%; in a living cohort it predicted CSF assay status with 79% accuracy. |
Accuracy for autopsy-confirmed Lewy body pathology and reduction in confirmatory CSF testing | cohort study | 1,567 | Among 358 autopsied participants, the two-step workflow predicted brain LBP with high accuracy overall (94%), and within clinical subgroups (clinical parkinsonism=95%; clinical Alzheimer's disease [AD]=94%; clinically unimpaired [CU]=93%). It reduced the need for confirmatory CSF testing by 43% overall (23% clinical parkinsonism; 35% clinical AD; 80% CU). In an independent in vivo cohort (N=1209), the workflow predicted CSF α-syn SAA status with 79% accuracy and reduced CSF testing by 26% |
Nature Communications
2025 ✓ Peer-reviewed PMID 40764485 |
| Dementia care management / navigation Care, carers and services | Treatment |
Benefit
whyDirection is for the Care Ecosystem programme: total cost of care was $475.80 per member per month lower than matched controls at 12 months, with fewer emergency, outpatient and professional visits. |
Total cost of care per member per month at 12 months versus propensity-matched controls | cohort study | 242 | Care Ecosystem participants had significantly lower total cost of care at 12 months, mean savings of $475.80 per member per month compared with controls |
American Journal of Managed Care
2024 ✓ Peer-reviewed PMID 39146484 |
| Naturalistic driving behaviour (digital marker of MCI) Care, carers and services | Treatment |
Benefit
whyDirection is for the test's accuracy against the reference standard; an accuracy result, not a health outcome. Driving features distinguished drivers with MCI from those with normal cognition (AUC 0.82), rising to 0.87 with demographics, APOE4 and cognition; drivers with MCI showed greater declines in trip frequency, night driving and route variety. |
Discrimination of MCI from normal cognition by daily driving features, and longitudinal change in driving | cohort study | 298 | Key features such as medium trip distance, speeding events, entropy, and maximum distance distinguished drivers with MCI from those with NC (area under the curve [AUC] 0.82, 95% CI 0.75-0.89). Adding demographics, APOE ε4, and cognitive composite improved AUC to 0.87 (95% CI 0.81-0.93) |
Neurology
2025 ✓ Peer-reviewed PMID 41296993 |
| Antipsychotics (harms / discontinuation) Medicines | Treatment |
Benefit
whyDirection is for STOPPING the antipsychotic: discontinuers were hospitalised less than matched continuers. |
Hospitalisation, pneumonia and urinary tract infection | cohort study | 4,222 | All-cause hospitalisation HR 0.83 (95% CI 0.72-0.96); pneumonia hospitalisation HR 0.51 (0.29-0.90) |
Alzheimer's Research & Therapy
2026 ✓ Peer-reviewed PMID 42410659 |
| Antipsychotics (harms / discontinuation) Medicines | Treatment |
Benefit
whyDirection is for discontinuation: tapering after 12 weeks lowered the 24-month absolute risk of delirium and fracture versus continuing, with no difference in stroke, pneumonia or death. Results were similar for abrupt discontinuation and after 24 weeks. |
24-month risk of delirium, fracture, stroke, pneumonia and death after tapering or stopping antipsychotics versus continuing | cohort study | 24,822 | Compared with continuation after 12 weeks of treatment, estimated risks of delirium and fracture under the tapering strategy corresponded to 24-month ARDs of -2·46% (95% CI -4·10 to -1·27) and -2·80% (-4·14 to -1·29), respectively. Estimated risks for stroke, pneumonia, and all-cause mortality were similar between strategies |
The lancet. Healthy longevity
2026 ✓ Peer-reviewed PMID 42302797 |
| Cholinesterase inhibitor / memantine Medicines | Treatment |
Benefit
whyObservational: 80% of residents were on no anti-dementia drug, so who gets prescribed and who does not may itself track prognosis. |
All-cause mortality | cohort study | 25,358 | Adjusted hazard ratios for mortality vs no anti-dementia drug: "HR: 0.826, 95%CI 0.769 to 0.888 for AChEI; 0.857, 95%CI 0.795 to 0.923 for memantine; 0.742, 95%CI 0.640 to 0.861 for AChEI plus memantine" |
Alzheimer's Research & Therapy
2024 ✓ Peer-reviewed PMID 38812028 |
| Cholinesterase inhibitor / memantine Medicines | Treatment |
Benefit
whyCholinesterase inhibitors, not memantine: -0.39 MMSE points a year against -2.50 with no treatment. The mortality benefit held only in the first year. Registry data with weighting, not a trial. |
MMSE decline per year; mortality | cohort study | 1,095 | MMSE change: -0.39 points/year (95% CI -0.96 to 0.18) with cholinesterase inhibitors vs -2.49 (-4.02 to -0.97) with memantine and -2.50 (-4.28 to -0.73) with non-use. Mortality in the first year after diagnosis: adjusted HR 0.66 (95% CI 0.46 to 0.94) |
Alzheimer's & Dementia
2024 ✓ Peer-reviewed PMID 39177108 |