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Blood-based biomarkers for detecting Alzheimer's disease pathology in cognitively impaired individuals within specialized care settings: A systematic review and meta-analysis
Pahlke S, Kahale LA, Mahinrad S, Sousa-Pinto B, Vieira RJ, McAteer MB, Claessen T, Contador J, Hofmann A, Kuchenbecker LA, et al.. Alzheimer's & Dementia, 2025-11-05
Topic: Amyloid, tau and blood-test diagnosis
Studies evaluating the diagnostic test accuracy of plasma phosphorylated tau (p-tau) and amyloid beta (Aβ) tests (p-tau217, %p-tau217, p-tau181, p-tau231, and Aβ42/Aβ40) compared to reference standard tests (cerebrospinal fluid [CSF] AD biomarkers, amyloid positron emission tomography [PET], or neuropathology) in individuals with cognitive impairment (mild cognitive impairment or dementia) in specialized care settings were included. Across a range of pre-test probabilities, we evaluated how much a positive or a negative test result would lead to a change in the probability of having amyloid positivity (post-test probability). Results Across 49 observational studies meeting eligibility criteria, 31 different BBM tests were examined. The review underscores that BBM test performance is assay- and platform specific and advises clinicians and laboratory directors to interpret results in the context of the specific test used and integrate the results with a comprehensive clinical assessment.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Pahlke, S., Kahale, L. A., Mahinrad, S., Sousa-Pinto, B., Vieira, R. J., McAteer, M. B., et al. (2025). Blood-based biomarkers for detecting Alzheimer's disease pathology in cognitively impaired individuals within specialized care settings: A systematic review and meta-analysis. Alzheimer's & Dementia. https://doi.org/10.1002/alz.70828
Vancouver
Pahlke S, Kahale LA, Mahinrad S, Sousa-Pinto B, Vieira RJ, McAteer MB, et al. Blood-based biomarkers for detecting Alzheimer's disease pathology in cognitively impaired individuals within specialized care settings: A systematic review and meta-analysis. Alzheimer's & Dementia. 2025. doi:10.1002/alz.70828. PMID: 41193403.
BibTeX
@article{pahlke2025-41193403,
author = {Pahlke, S. and Kahale, L. A. and Mahinrad, S. and Sousa-Pinto, B. and Vieira, R. J. and McAteer, M. B. and Claessen, T. and Contador, J. and Hofmann, A. and Kuchenbecker, L. A. and others},
title = {{Blood-based biomarkers for detecting Alzheimer's disease pathology in cognitively impaired individuals within specialized care settings: A systematic review and meta-analysis}},
journal = {Alzheimer's \& Dementia},
year = {2025},
doi = {10.1002/alz.70828},
pmid = {41193403},
url = {https://doi.org/10.1002/alz.70828}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Studies evaluating the diagnostic test accuracy of plasma phosphorylated tau (p-tau) and amyloid beta (Aβ) tests (p-tau217, %p-tau217, p-tau181, p-tau231, and Aβ42/Aβ40) compared to reference standard tests (cerebrospinal fluid [CSF] AD biomarkers, amyloid positron emission tomography [PET], or neuropathology) in individuals with cognitive impairment (mild cognitive impairment or dementia) in specialized care settings were included.
- Across a range of pre-test probabilities, we evaluated how much a positive or a negative test result would lead to a change in the probability of having amyloid positivity (post-test probability).
- Results Across 49 observational studies meeting eligibility criteria, 31 different BBM tests were examined.
- The review underscores that BBM test performance is assay- and platform specific and advises clinicians and laboratory directors to interpret results in the context of the specific test used and integrate the results with a comprehensive clinical assessment.
Why it matters
This review of 49 studies examined how well plasma p-tau and amyloid beta tests detect Alzheimer's disease pathology in people with cognitive impairment in specialized care settings. It found that test performance is specific to the assay and platform used, and advises clinicians to interpret results in the context of the specific test and integrate them with a comprehensive clinical assessment.
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Study details
- Study designmeta-analysis
- Effect sizeSensitivity 49.3-91.4% and specificity 61.5-96.7% across 31 blood tests
- Evidence strengthModerate
Limitations
Only specialised-care populations; single cut-point analyses may understate two-threshold approaches; rapidly evolving field so estimates date quickly; heterogeneity across platforms.
How this study scored 63/100
Published in a leading specialty journal, and it is a meta-analysis pooling many studies. Scored zero for sample size and studied in people because the record does not state it. We have no data on free to read, so that was left out: it earned 62 of the 98 points we could judge it on, which is 63 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | A review of other studies — randomization is not credited here |
| Times cited | 3 / 7 | Cited 33 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 11.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 7.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 2 / 4 | Cited 33 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Malavika P. Tampi: h-index 18 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,962 (OpenAlex) |
| Multicenter collaboration | 3 / 3 | OpenAlex lists 21 institution(s) in 6 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41193403) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 62 / 98 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 62 of the 98 points we could judge it on is 63 out of 100. |
| Total | 63 / 100 | — |
What each of these 20 components measures, and what this score is not →
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