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Attitudes toward clinical trials across the Alzheimer’s disease spectrum

Overview of attention for article published in Alzheimer's Research & Therapy, October 2017
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Title
Attitudes toward clinical trials across the Alzheimer’s disease spectrum
Published in
Alzheimer's Research & Therapy, October 2017
DOI 10.1186/s13195-017-0311-5
Pubmed ID
Authors

Michelle M. Nuño, Daniel L. Gillen, Kulwant K. Dosanjh, Jenny Brook, David Elashoff, John M. Ringman, Joshua D. Grill

Abstract

Research has revealed that manifest Alzheimer's disease (AD) dementia is preceded by preclinical and prodromal phases during which pathology is accumulating but function remains intact. This understanding and concern that disease-modifying interventions initiated at the dementia stage may come too late in the neurodegenerative process to be successful has led to a paradigm shift in AD clinical trials. AD trials now enroll patients with mild cognitive impairment (MCI) and persons with no cognitive symptoms. Trial designs are similar to those enrolling dementia participants. We set out to test the hypothesis that attitudes towards trial design features differ among different potential AD trial populations. We sent a survey composed of 37 items assessing specific trial elements to 246 cognitively normal, MCI, and AD dementia participants at the University of California Los Angeles (UCLA) Alzheimer's Disease Research Center (ADRC), from whom we received 91 responses (37 cognitively normal, 32 MCI, and 22 dementia). To quantify willingness to enroll, we created three composite scenarios by summing responses and fitting proportional odds models with a binary outcome variable for whether patients were highly willing to participate in low-, moderate-, or high-risk and burden trials. MCI participants less frequently correctly self-identified their diagnoses than those with dementia or normal cognition. Compared to dementia patients, the odds of participating in a low-risk, low-burden trial were 12% lower for MCI patients (odds ratio (OR) = 0.88, 95% confidence interval (CI) 0.23-3.29) and 70% lower (OR = 0.30, 95% CI 0.08-1.09) for cognitively normal participants. With increasing risk and burden, willingness to enroll decreased and the gap in relative willingness between diagnostic groups increased. In the medium-risk, medium-burden scenario, the estimated OR was 0.64 (95% CI 0.17-2.40) for MCI and 0.21 for the cognitively normal (95% CI 0.06-0.77). In the high-risk, high-burden scenario, the estimated OR indicated reduced willingness for MCI (OR = 0.27, 95% CI 0.06-1.15) and cognitively normal respondents (OR = 0.12, 95% CI 0.03-0.54). These results suggest that AD trials enrolling predementia populations, especially those requiring frequent visits and implementing biomarker testing procedures, may encounter challenges to enrollment.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 47 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 9 19%
Student > Ph. D. Student 8 17%
Student > Master 6 13%
Student > Bachelor 6 13%
Student > Doctoral Student 3 6%
Other 6 13%
Unknown 9 19%
Readers by discipline Count As %
Neuroscience 6 13%
Medicine and Dentistry 6 13%
Psychology 4 9%
Social Sciences 4 9%
Agricultural and Biological Sciences 3 6%
Other 12 26%
Unknown 12 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 October 2017.
All research outputs
#9,479,999
of 11,868,523 outputs
Outputs from Alzheimer's Research & Therapy
#445
of 497 outputs
Outputs of similar age
#199,322
of 272,685 outputs
Outputs of similar age from Alzheimer's Research & Therapy
#18
of 20 outputs
Altmetric has tracked 11,868,523 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 497 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.3. This one is in the 3rd percentile – i.e., 3% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 272,685 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 15th percentile – i.e., 15% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 20 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.