Screening for Alzheimer’s is a diagnostic bridge to nowhere

Doctor, do you really want to know if your patient has a chronic, slowly progressive, fatal, debilitating disease for which you have no effective intervention?

Patient, do you really want to know if you have a chronic, slowly progressive, fatal, debilitating disease for which medicine has no effective intervention?

If you two together (along with family members) answer yes to that question, then the florbetapir-assisted PET scan of the brain for amyloid is for you.

If the FDA follows the advice of the advisory committee, once the manufacturer succeeds in running its new product through a few more hoops, you can find out with substantial certainty whether the patient has amyloid brain plaques and thus presumptive Alzheimer’s disease.

Then what? Nothing medical.

I am glad if finally there really will be a definitive way to diagnose amyloid plaques characteristic of Alzheimer’s prior to autopsy.

I believe that there can be real value in having such a test available in order to study the effects of rational potential drug therapy on the progression, or ideally the stabilization or regression, of the amyloid plaques.

But that is research, after fully informed consent, presumably usually in a setting of clinical trials.

As I wrote and spoke a few months ago, I implore physicians and patients to resist the inevitable marketing hype to use this test in any setting other than research.

It truly is a “Diagnostic Bridge to Nowhere.”

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

Originally published in MedPage Today. Visit MedPageToday.com for more health policy news.

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