Reporting standards for studies of diagnostic test accuracy in dementia: The STARDdem Initiative

OBJECTIVE: To provide guidance on standards for reporting studies of diagnostictest accuracy for dementia disorders.METHODS: An international consensus process on reporting standards in dementia and cognitive impairment (STARDdem) wasestablished, focusing on studies presenting data from which sensitivity andspecificity were reported or could be derived. A working group led the initiativethrough 4 rounds of consensus work, using a modified Delphi process andculminating in a face-to-face consensus meeting in October 2012. The aim of this process was to agree on how best to supplement the generic standards of the STARDstatement to enhance their utility and encourage their use in dementiaresearch.RESULTS: More than 200 comments were received during the widerconsultation rounds. The areas at most risk of inadequate reporting wereidentified and a set of dementia-specific recommendations to supplement the STARDguidance were developed, including better reporting of patient selection, thereference standard used, avoidance of circularity, and reporting of test-retestreliability.CONCLUSION: STARDdem is an implementation of the STARD statement inwhich the original checklist is elaborated and supplemented with guidancepertinent to studies of cognitive disorders. Its adoption is expected to increasetransparency, enable more effective evaluation of diagnostic tests in Alzheimerdisease and dementia, contribute to greater adherence to methodologic standards, and advance the development of Alzheimer biomarkers.