READ-OUT - REAl World Dementia OUTcomes: Observational Study
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 3,165
- 试验地点
- 27
- 主要终点
- Diagnostic accuracy of blood-based biomarkers for dementia diagnosis
研究概览
简要总结
READ-OUT observational study will investigate blood-based biomarkers for dementia in real-world clinical settings. This 3-year observational study will include 3165 people, males or females aged 45 years or older, with cognitive impairment of any severity.
Participants provide blood samples and complete questionnaires about quality of life and healthcare use, with some having additional follow-ups at 2 weeks and 1 year. The study will assess reliability and accuracy of blood tests in diagnosing dementia.
详细描述
Dementia affects a growing number of people in the UK, with significant costs for individuals, families, and society. There is an urgent need for accurate diagnosis of dementia to allow early intervention and support when people can still make decisions about their care.
Current dementia diagnosis in memory clinics relies on clinical assessment, cognitive testing, and brain scans (MRI or CT). Only a small proportion of UK patients have access to more specific tests like PET brain scans or spinal fluid analysis, which are expensive and not widely available.
Recent developments have shown that blood tests can accurately detect the underlying brain changes of dementia, particularly Alzheimer's disease. In research studies, these blood-based biomarkers (ptau217, AB42/40 ratio, GFAP, NFL etc) have successfully identified people with Alzheimer's disease when compared to clinical diagnoses, gold standard brain scans, and post-mortem brain examination. These blood tests also show promise for predicting people with future dementia risk.
However, most research has been conducted in younger, less diverse populations than those seen in real-world memory services. Blood-based biomarkers are not yet used in routine NHS practice, and more work is needed to test how well they perform in representative UK populations. We also need to understand whether people want to know their blood test results, what information they want, and how this is best communicated.
The READ-OUT study will test blood-based biomarkers in people attending memory clinics across the UK (30 NHS sites), ensuring participants represent the full diversity of people with dementia or memory concerns (30% from underrepresented groups). Participants will provide a 40ml blood sample and complete questionnaires about quality of life, healthcare use, and attitudes toward blood testing for dementia. The accuracy of blood biomarkers will be compared against established diagnostic methods including expert clinical review, brain scans, spinal fluid tests, and long-term health record follow-up.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 45 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •The participant may enter the study if ALL of the following apply:
- •Willing and able to give informed consent for participation in the study (translation needs for study information and forms for non-English speakers will be defined locally) OR Adults who otherwise lack the capacity to consent but for whom advice regarding participation has been obtained via a consultee using the personal or nominated consultee process
- •Male or Female, aged 45 years and above
- •Referred or referable with cognitive or behavioural symptoms and/or diagnosed with a cognition related disorder; including those with subjective cognitive impairment and functional disorders.
排除标准
- •The participant may not enter the study if ANY of the following apply:
- •Lack of venous access
- •Unwilling to consent to NHS data linkage or in Northern Ireland, unwilling to allow long term follow up by access to electronic NHS records.
结局指标
主要结局
Diagnostic accuracy of blood-based biomarkers for dementia diagnosis
时间窗: baseline and at 52 weeks
Accuracy, Positive and Negative predictive value in regard to diagnosis and, where available, gold standard biomarker measures (clinical consensus, cerebrospinal fluid, CSF, positron emission tomography, PET)
Feasibility and acceptability of blood-based biomarkers for dementia diagnosis
时间窗: baseline, at 2 weeks and 52 weeks
Recruitment metrics at site level Acceptability patient questionnaires Patient and Public Involvement qualitative data around acceptability of BBM collection
Cost-effectiveness of blood biomarkers in a real-world cognitive disorders population
时间窗: baseline and at 52 weeks
Health-related quality of life (HR-QoL) Healthcare utilisation
次要结局
- Optimal individual or sets of biomarkers for separate dementia aetiologies(baseline, at 2 weeks and 52 weeks)
- Impact of sample processing delays on the accuracy of blood biomarkers(Baseline study visit)
- Disease prediction utility of blood-based biomarkers in diverse cognitive disorders populations(baseline and at 52 weeks)
- The utility of remote blood test kits(Baseline study visit)
- Understanding participant preferences on disclosure of biomarker status in dementia diagnosis(baseline and at 52 weeks)
- The test-retest reliability of blood biomarkers(Baseline study visit, 1-2 week visit)