Presentations

Read research from Cogstate scientists as presented at industry conferences.

Leveraging Remote Assessments and Central Raters to Optimize Data Quality in Rare Neurodevelopmental Disorders

Presented at the European Conference on Rare Disease 2022

Fully remote or hybrid administration of clinical outcome measures in rare neurodevelopmental disorders trials is increase due to the ongoing pandemic and recognition that remote assessments reduce burden on families. Many assessments in rare neurodevelopmental disorders trials are complex. Remote/hybrid trials readily allow for the use of centralized raters to administer/score scales. This poster explores the data quality impact of leveraging centralized raters.

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Validity and reliability of a composite cognitive outcome measure for clinical trials in dementia with Lewy bodies

Presented at AD/PD 2022

Both the FDA and a number of industry bodies including the International Society for Pharmacoeconomics and Outcomes Research ‘ISPOR’ place considerable emphasis on patient focused drug development and have sought to develop guidance and good practice that ensures patient centricity. PerfO assessments may be particularly valuable sources of information regarding treatment benefit where patient populations have substantial difficulty in providing reliable self-report and/or where concepts of interest for measurement are difficult to observe, or impractical or difficult to measure. This is particularly the case for dementia and other diseases and conditions where cognitive impairment is a prominent feature.

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Disease specific global clinical rating scales for Lewy-body dementia: early concept identification

Presented at AD/PD 2022

In several areas of clinical research, expert groups have sought to develop global instruments which are disease specific. Discussions are underway to develop such a tool for Dementia with Lewy Bodies (DLB). An initial component of this research is understanding the signs and symptoms considered important in a global assessment of the severity of DLB. Data consolidated here come from literature reviews and exploration of reported clinical trial designs. The most frequently used COAs were the CDR, NPI, and MMSE, suggesting a comprehensive and relevant global DLB instrument should include a range of motor, cognitive, neuropsychiatric, and functional domains.

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Monthly at-home computerized cognitive testing to detect diminished practice effects in preclinical Alzheimer’s disease

Presented at CTAD 2021

A major challenge for Alzheimer’s disease (AD) secondary prevention trials is the long and subtle course of cognitive decline observed in individuals with preclinical AD. Computerized testing has the potential to capture subtle cognitive change more rapidly, by enabling standardized administration and data analyses allowing for remote, unsupervised, and more frequent assessments. The higher frequency assessments afforded through the use of computerized testing enable the study of practice effects (PE) that can occur with repeated assessments in older adults, and which previously has been shown to provide a meaningful cognitive marker in preclinical AD.

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Rater Academy: Increasing efficiency in training clinicians within Rare Disease trials

Presented at NORD 2021

Clinicians participating in Rare Disease clinical trials range in their level of experience with specific outcome measures. Some measures require an advanced degree and some are completed by junior staff. The Vineland Adaptive Behavior Scale, Third Edition (Vineland-3) is a caregiver interview commonly used in Rare Disease trials, specifically developmental disabilities trials.

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CBB in ADNI-3 Valid In-Clinic and At-Home

Presented at AD/PD 2021

Recent data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) show the Cogstate Brief Battery (CBB) to be valid and sensitive for in-clinic and at-home assessment in both cognitively normal and MCI populations. ADNI is a landmark longitudinal multicenter study designed to develop biomarkers for the early detection of AD. In this video, Dr. Chris Edgar recaps his AD/PD presentation, which discusses the data collected during ADNI-3 demonstrating known-groups validity, equivalence between in-clinic and at-home assessment, and longitudinal sensitivity of the CBB.

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Initial exploration of a brain age score based on validated computerized cognitive assessments in Japanese individuals

Presented at AAIC 2020

Cognitive and/or neuropsychological tests typically have abstract outcome measures, where the clinical meaning of scores is not readily apparent. For clinicians, this is commonly achieved through an understanding of the normal distribution of scores, for example bone density t-scores in evaluating osteoporosis. This may not be well understood by patients and study participants though, and here the concept of being ‘normal for one’s age’ may also be valuable. A difference between chronological age and biological age has been used to more easily communicate health related information. Our team aimed to develop a ‘Brain Age’ score for communicating cognitive test performance.

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Using imputation to harmonize longitudinal measures of cognition across two large cohorts: AIBL and ADNI

Presented at AAIC 2020

To ensure the generalizability of findings and consider more nuanced hypotheses, larger sample sizes are required. Combining data from different but similar study cohorts is one solution. However, the disparity of these datasets, e.g. using differing tests to assess specific cognitive domains, makes this a non-trivial task. Here, we propose a harmonization solution using imputation strategies for cognitive memory performance in AIBL2 and ADNI3.

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Plasma Aβ biomarker associated with cognitive decline in preclinical Alzheimer’s disease

Presented at AAIC 2020

We recently showed in two independent cohorts, that a plasma Aβ composite biomarker, which was generated by combining plasma ratios of APP 669 711 /Aβ 1 42 and Aβ 1 40 /Aβ 1 42 as measured by immunoprecipitation mass spectrometry (IP-MS) assay, had very high areas under the receiver operating characteristic curves (AUCs) (94-96%), with an accuracy of ~90% for the classification of high Aβ levels based on Pittsburgh Compound B PiB PET. This plasma Aβ composite biomarker may therefore have great clinical utility for predicting Aβ levels. We aimed to examine the relationship between this plasma Aβ composite biomarker and cognitive function in cognitively normal older adults in two independent cohorts.

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Development of the Snellen Memory Test (SMT): An episodic memory test to screen for AD risk in a clinical optometry/ophthalmology setting

Presented at AAIC 2020

Retinal biomarkers are an ideal target for AD risk biomarker development: the retina shares neurobiology and neurochemistry with the central nervous system (CNS), and can be visualized using standard optometry and ophthalmology techniques. Retinal imaging using spectral domain optical coherence tomography (SD-OCT) is minimally invasive, cost-effective, highly accessible, and can be implemented by point-of-care clinicians in clinical optometry and ophthalmology practices. Because many adults over the age of 40 regularly see an eye-care professional for routine care and prescription adjustments for corrective lenses, assessment of AD risk in clinical optometry practice provides an ideal opportunity for high volume screening of large portions of the population.

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