Automated quantitative MRI volumetry reports support diagnostic interpretation in dementia: a multi-rater, clinical accuracy study

Objectives: We examined whether providing a quantitative report (QReport) of regional brain volumes improves radiologists’ accuracy and confidence in detecting volume loss, and in differentiating Alzheimer’s disease (AD) and frontotemporal dementia (FTD), compared with visual assessment alone. Methods: Our forced-choice multi-rater clinical accuracy study used MRI from 16 AD patients, 14 FTD patients, and 15 healthy controls; age range 52–81. Our QReport was presented to raters with regional grey matter volumes plotted as percentiles against data from a normative population (n = 461). Nine raters with varying radiological experience (3 each: consultants, registrars, ‘non-clinical image analysts’) assessed each case twice (with and without the QReport). Raters were blinded to clinical and demographic information; they classified scans as ‘normal’ or ‘abnormal’ and if ‘abnormal’ as ‘AD’ or ‘FTD’. Results: The QReport improved sensitivity for detecting volume loss and AD across all raters combined (p = 0.015* and p = 0.002*, respectively). Only the consultant group’s accuracy increased significantly when using the QReport (p = 0.02*). Overall, raters’ agreement (Cohen’s κ) with the ‘gold standard’ was not significantly affected by the QReport; only the consultant group improved significantly (κs 0.41➔0.55, p = 0.04*). Cronbach’s alpha for interrater agreement improved from 0.886 to 0.925, corresponding to an improvement from ‘good’ to ‘excellent’. Conclusion: Our QReport referencing single-subject results to normative data alongside visual assessment improved sensitivity, accuracy, and interrater agreement for detecting volume loss. The QReport was most effective in the consultants, suggesting that experience is needed to fully benefit from the additional information provided by quantitative analyses. Key Points: • The use of quantitative report alongside routine visual MRI assessment improves sensitivity and accuracy for detecting volume loss and AD vs visual assessment alone. • Consultant neuroradiologists’ assessment accuracy and agreement (kappa scores) significantly improved with the use of quantitative atrophy reports. • First multi-rater radiological clinical evaluation of visual quantitative MRI atrophy report for use as a diagnostic aid in dementia

Keynes on Global Economic Integration

B31,

Valuing research: tools and approaches for assessing and enhancing the benefits from environmental research

This project has developed and tested a framework for assessing research value across the life cycle of conservation research projects and programs. This is the first comprehensive attempt of its kind to build and test a multimodal, integrated, qualitative and quantitative framework for achieving and assessing value in environmental research. The report focuses on research ‘value’, not just ‘impact’. Achieving research value is strongly dependent on effective engagement and building appropriate ‘pathways to impact’. The framework is designed as a flexible guide that can be drawn upon for a wide range of valuation purposes, and that can be applied (as appropriate) at any point through the life cycle of research projects or after completion. It is designed for practical application in agencies across a wide range of sectors, including research, research funding, government and land management agencies

Australia's biodiversity crisis and the need for the Biodiversity Council

Australia is a mega-biodiverse region. Millions of years of geographical isolation have resulted in high species diversity and endemism. So far, >21 000 species of plants, 8000 species of vertebrates, and 110 000 species of insects and other invertebrates have been described (Chapman 2009). An exceptionally high percentage are endemic; 93% of flowering plants, >80% of invertebrates, 87% of mammals, 93% of reptiles, 94% of frogs, 74% of freshwater fishes and >50% of temperate marine fishes in Australia are found nowhere else (Lintermans 2013; Cresswell & Murphy 2017)