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Doubts about clinical relevance, measuring technique

Posted by euthman on 10 Sep 2010 at 13:42 GMT

First of all, most radiologists don't even mention brain atrophy in MRI reports, because there is little or no correlation between apparent atrophy and brain function. Reporting it only causes the patients and their doctors problems when they or a potential insurer reads it. Second, using MRI for quantitative assessment of brain atrophy has "not reached the mainstream" of radiology (according to our hospital radiologist, who is recently out of training, therefore probably up to date on the latest). Third, I am very skeptical that a sampling technique such as MRI can measure volume changes at the levels of precision they are reporting here (1% and less). Where is there validation of this technique against actual brain weights at autopsy? Fourth, the scatter plots showing results are far, far from convincing. If there is any protective effect vis-a-vis placebo, there is much more variation within each group (treated and placebo) than between the two groups.

Fifth (and IMO the biggest problem), they tested a proprietary combination vitamin product which allegedly contains folate, B6, and B12. They did not mention that the products were independently assayed for composition. (In the United States nutritional supplements do not fall under the FDA regulatory umbrella.)

No competing interests declared.