Supplementary Material for: Effectiveness of Florbetapir PET Imaging in Changing Patient Management

<p><b><i>Aims:</i></b> To evaluate the impact of amyloid PET imaging on diagnosis and patient management in a multicenter, randomized, controlled study. <b><i>Methods:</i></b> Physicians identified patients seeking a diagnosis for mild cognitive impairment or dementia, possibly due to Alzheimer disease (AD), and recorded a working diagnosis and a management plan. The patients underwent florbetapir PET scanning and were randomized to either immediate or delayed (1-year) feedback regarding amyloid status. At the 3-month visit, the physician updated the diagnosis and recorded a summary of the actual patient management since the post-scan visit. The study examined the impact of immediate versus delayed feedback on patient diagnosis/management at 3 and 12 months. <b><i>Results:</i></b> A total of 618 subjects were randomized (1:1) to immediate or delayed feedback arms, and 602 subjects completed the 3-month primary endpoint visit. A higher proportion of patients in the immediate feedback arm showed a change in diagnosis compared to the controls (32.6 vs. 6.4%; <i>p</i> = 0.0001). Similarly, a higher proportion of patients receiving immediate feedback had a change in management plan (68 vs. 55.5%; <i>p</i> < 0.002), mainly driven by changes in AD medication. Specifically, acetylcholinesterase inhibitors were prescribed to 67% of the amyloid-positive and 27% of the amyloid-negative subjects in the information group compared with 56 and 43%, respectively, in the control group (<i>p</i> < 0.0001). These between-group differences persisted until the 12-month visit. <b><i>Conclusion:</i></b> Knowledge of the amyloid status affects the diagnosis and alters patient management.</p