Objectives: DISCERN^TM is a novel test combining three biomarkers: Morphometric Imaging (measures fibroblasts ability to form networks), Protein Kinase C ε (measures synaptic growth), and AD-Index (measures phosphorylation of Erk1 and Erk2 in response to bradykinin). DISCERN^TM is the only AD diagnostic validated against autopsy confirmed diagnosis (NIH gold standard for AD diagnosis) with 95% sensitivity and 95% specificity. This research explores the clinical utility of the novel DISCERN^TM test.

Methods: A web survey-based conjoint analysis estimated preferences from a sample of PCPs, neurologists, and geriatricians. Hypothetical patient profiles were created with five attributes: MRI/CT Scan results, MMSE score, Blood test results (TSH, Vitamin B12, Folate, Syphilis, Lyme disease), Age, and DISCERN^TM result. Physicians viewed seven randomly selected from a fractional factorial design of 27 unique profiles. For each patient, physicians indicated whether or not they would Diagnose AD, Prescribe medications for AD cognitive impairment, Refer to a neurologist (PCPs and geriatricians only) or Prescribe futuristic disease-modifying Drug X. Aggregate logit models assessed attribute importance.

Results: 402 physicians participated (250 PCPs, 102 Neurologists, 50 Geriatricians). Only 4% physicians indicated extreme satisfaction with current AD tests, and 90% were likely to order DISCERN^TM. DISCERN^TM was an important attribute in physician decision-making and compared to no DISCERN^TM test a positive DISCERN^TM result was associated with: significantly higher odds of AD diagnosis (relative attribute importance (RAI):64%; OR:6.45; 95% CI:5.09-8.17), prescribing Drug X (RAI:62%; OR:4.12; 95% CI:3.36-5.04), and prescribing treatments for cognitive impairment (RAI:54%; OR:2.98; 95% CI:2.40-3.68), respectively; a negative DISCERN^TM test was associated with significantly lower odds of prescribing treatments for cognitive impairment (RAI:54%; OR:0.58; 95% CI:0.48-0.70), MMSE score was the most important attribute in decisions to refer to a neurologist (RAI:48%).

Conclusions: This implicit preference study indicates physicians will routinely use the results of DISCERN^TM in the diagnosis and management of AD.