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Background: A screening tool was devised to aid the diagnosis and treatment of ground‐glass nodules (GGNs). Methods: The current ambispective cohort study included retrospective collation of 20 variables synthesizing a patient's clinical characteristics, serum tumor markers, and CT results, which allowed division into noninvasive (benign, atypical adenomatous hyperplasia, and adenocarcinoma in situ) and invasive (minimally invasive and invasive adenocarcinomas) tumors to build a prediction nomogram and GGN screening scale. The model was verified internally. A prospective cohort of patients was randomly divided by envelope method into those assessed by the GGN screening scale and those assessed via CT values. The diagnostic efficiencies were compared to allow external verification of the model. Result: A total of 223 patients with 225 GGNs were recruited into the retrospective cohort between January 2021 and December 2022. Multivariable analysis showed sex, diameter, air bronchogram, and vessel convergence sign to be independent factors for prediction of noninvasive and invasive GGNs. Internal verification showed the model had a sensitivity of 70.7% and specificity of 75.0% with the Youden index at 0.457 and area under the curve (AUC) of 0.793 (95% CI: 0.734–0.852). Calibration curves indicated good internal stability (p = 0.357). Between January 2023 and March 2023, 147 patients with 148 GGNs were recruited into the prospective cohort. External verification showed the model had a sensitivity of 92.4% and specificity of 40.0% with the Youden index at 0.324 and AUC of 0.678 (95% CI: 0.509–0.847). Calibration curves indicated good external stability (p = 0.088). The scale was shown to have a sensitivity of 75.00%, specificity of 37.50%, positive predictive value of 91.53%, negative predictive value of 14.29%, and accuracy of 71.25%. Conclusion: The GGN screening scale has high sensitivity and accuracy, making it suitable for diagnosis of GGNs. [ABSTRACT FROM AUTHOR]

ABSTRACT Background A screening tool was devised to aid the diagnosis and treatment of ground‐glass nodules (GGNs). Methods The current ambispective cohort study included retrospective collation of 20 variables synthesizing a patient's clinical characteristics, serum tumor markers, and CT results, which allowed division into noninvasive (benign, atypical adenomatous hyperplasia, and adenocarcinoma in situ) and invasive (minimally invasive and invasive adenocarcinomas) tumors to build a prediction nomogram and GGN screening scale. The model was verified internally. A prospective cohort of patients was randomly divided by envelope method into those assessed by the GGN screening scale and those assessed via CT values. The diagnostic efficiencies were compared to allow external verification of the model. Result A total of 223 patients with 225 GGNs were recruited into the retrospective cohort between January 2021 and December 2022. Multivariable analysis showed sex, diameter, air bronchogram, and vessel convergence sign to be independent factors for prediction of noninvasive and invasive GGNs. Internal verification showed the model had a sensitivity of 70.7% and specificity of 75.0% with the Youden index at 0.457 and area under the curve (AUC) of 0.793 (95% CI: 0.734–0.852). Calibration curves indicated good internal stability (p = 0.357). Between January 2023 and March 2023, 147 patients with 148 GGNs were recruited into the prospective cohort. External verification showed the model had a sensitivity of 92.4% and specificity of 40.0% with the Youden index at 0.324 and AUC of 0.678 (95% CI: 0.509–0.847). Calibration curves indicated good external stability (p = 0.088). The scale was shown to have a sensitivity of 75.00%, specificity of 37.50%, positive predictive value of 91.53%, negative predictive value of 14.29%, and accuracy of 71.25%. Conclusion The GGN screening scale has high sensitivity and accuracy, making it suitable for diagnosis of GGNs.

This study aimed at deepening into the internal structure's analysis of the Argentinean Scale of Suicidality, Youth version—ASSY-I Screening—. The 6-factor model obtained in a previous exploratory factor study was tested via confirmatory factor analysis, and further compared with an alternative second-order model. The factorial invariance was examined using the self-perceived gender as a splitting variable. The factors' internal consistency was analysed in the whole sample and in two subsamples comprising exclusively men and women. The scores' stability-reliability was examined using a test-retest analysis. The sample was composed of 632 students with ages between 13 and 21 years old (M = 17.88, SD = 2.16; 64.08% women, 35.92% men). Results showed evidence favouring the robustness of the ASSY-I model as well as the likelihood of generalising it across groups in the local population of young students. Findings are discussed regarding further uses of the scale in the professional field. [ABSTRACT FROM AUTHOR]

Abstract Background Early morning off (EMO) is a common feature of Parkinson’s disease (PD). This study aimed to characterize its clinical features and develop a convenient and pragmatic self-assessment instrument in a Chinese nationwide population. Methods This study was conducted on 942 PD patients admitted to 55 clinic centers for movement disorders between June 2018 and May 2019 in China. Stepwise logistic regression analyses were performed to determine potential risk factors and the most predictive symptoms of EMO, as well as whether EMO was an independent risk factor of functional dependency in daily life. Based on this, a 7-question scale was derived for EMO screening. Diagnostic accuracy of this scale was assessed from the area under the receiver operative characteristic curve (AUROC) and its 95% confidence intervals (CIs). We further calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the optimal cutoff point. Results EMO occurred in 49.2% of PD patients across all disease stages. We identified 7 symptoms most predictive of EMO, including bradykinesia or rigidity, excessive sweating or salivation, difficulty in turning on or getting out of bed, muscle cramp, fatigue or sleepiness, frozen state or freezing gait, and tremor. The resulting 7-item scale was confirmed to be of good discrimination with a relatively large AUROC of 0.83, a relatively high sensitivity of 75.7%, specificity of 77.5%, PPV of 76.5%, and NPV of 76.7%. Nonideal nighttime sleep, long PD duration, advanced H&Y stages, posture instability gait difficulty-dominant or mixed subtypes, and high levodopa dose were independently associated with increased risk of EMO. EMO patients were at 87% higher (OR = 1.87, 95%CI: 1.07–3.32) risk of experiencing functional dependency in daily living compared with their counterparts. Conclusions We demonstrated that EMO is a common feature for PD patients across all disease stages and put forward an EMO-specific screening card of sufficient accuracy and brevity. Meanwhile we have thrown some light upon potential determinants and negative health effects of EMO. Our findings may exert great impact on improving the awareness, recognition and management of EMO in PD patients.

Background: Early morning off (EMO) is a common feature of Parkinson's disease (PD). This study aimed to characterize its clinical features and develop a convenient and pragmatic self-assessment instrument in a Chinese nationwide population. Methods: This study was conducted on 942 PD patients admitted to 55 clinic centers for movement disorders between June 2018 and May 2019 in China. Stepwise logistic regression analyses were performed to determine potential risk factors and the most predictive symptoms of EMO, as well as whether EMO was an independent risk factor of functional dependency in daily life. Based on this, a 7-question scale was derived for EMO screening. Diagnostic accuracy of this scale was assessed from the area under the receiver operative characteristic curve (AUROC) and its 95% confidence intervals (CIs). We further calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the optimal cutoff point. Results: EMO occurred in 49.2% of PD patients across all disease stages. We identified 7 symptoms most predictive of EMO, including bradykinesia or rigidity, excessive sweating or salivation, difficulty in turning on or getting out of bed, muscle cramp, fatigue or sleepiness, frozen state or freezing gait, and tremor. The resulting 7-item scale was confirmed to be of good discrimination with a relatively large AUROC of 0.83, a relatively high sensitivity of 75.7%, specificity of 77.5%, PPV of 76.5%, and NPV of 76.7%. Nonideal nighttime sleep, long PD duration, advanced H&Y stages, posture instability gait difficulty-dominant or mixed subtypes, and high levodopa dose were independently associated with increased risk of EMO. EMO patients were at 87% higher (OR = 1.87, 95%CI: 1.07–3.32) risk of experiencing functional dependency in daily living compared with their counterparts. Conclusions: We demonstrated that EMO is a common feature for PD patients across all disease stages and put forward an EMO-specific screening card of sufficient accuracy and brevity. Meanwhile we have thrown some light upon potential determinants and negative health effects of EMO. Our findings may exert great impact on improving the awareness, recognition and management of EMO in PD patients. [ABSTRACT FROM AUTHOR]

COVID-19 is a huge global challenge, on which numerous people and resources all over the world have been focused over the last three years to slow down its spread. A screening scale for the early detection of COVID-19 cases is highly important to diagnose patients before they transmit the disease to others. Using the data collected from Sept. 2020 to Nov. 2020 from 12,123 employees of a company including a weekly self-report questionnaire and information on their demographics, chronic disease, work, and commute, we developed a short, optimized screening scale for the early detection of COVID-19. To develop the scale, we have modified an interpretable machine learning (ML) method which uses integer programming​ techniques, and consequently reduced its computational cost significantly and made it robust to erroneous data and protective of sensitive information without loss of performance. The developed scale is highly interpretable and easily scored to the extent that it does not require a computer or even a calculator. However, we showed that the operating characteristics of the screening scale on the test dataset are excellent (area under the ROC curve = 82% and area under the Precision–Recall curve = 27%) and comparable to other well-known ML models such as penalized logistic regression and random forest when predicting positive PCR test results within 7 days from the date the self-report questionnaire was filled out. From Dec. 2020 to Nov. 2021, the developed scale has been used in the company weekly to monitor and assess its employees. Although different variants of COVID-19 have emerged since the development of the scale, the results show that the scale has performed well in the early detection of COVID-19, which helped the company take appropriate actions to slow down the spread of COVID-19 among its employees successfully. We expect our findings in this paper to help researchers have a better understanding of COVID-19 and control the spread of the disease. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop and validate a gaming disorder screening scale based on the ICD-11 criteria for Gaming disorder. 12 main items and 5 supplementary items were created to measure functional impairment and the three basic criteria of ICD-11 for gaming disorder. A total of two samples were used to select items and analyze psychometric properties. The first sample was collected from 252 adolescents and adults who had regular game use experience, some of which corresponded to Repeated measurement data were collected after 6 weeks on 202 subjects. The second sample data was collected from 132 people in the game disorder subclinical group. In both samples, a single-factor model best explained the data. A total of 9 questions were finally selected among the main questions, and the questions showed high factor loadings and reliability. In addition, as a result of evaluating validity through correlation analysis with factors related to gaming disorder, all showed excellent official validity and convergent validity. As a result of the ROC analysis, the total score was determined as 10 points for the criteria for the classification of game disorder risk groups in the finalized selection tool. [ABSTRACT FROM AUTHOR]

Background: Cerebrospinal fluid (CSF) biomarkers (Aβ peptides and tau proteins) improved the diagnosis of Alzheimer’s disease (AD) in research and clinical settings. We previously described the PLM-scale (Paris-Lille-Montpellier study), which combines Aβ42, tau, and phosphorylated ptau(181) biomarkers in an easy to use and clinically relevant way. The purpose of this work is to evaluate an optimized PLMR-scale (PLM ratio scale) that now includes the Aβ42/Aβ40 ratio to detect AD versus non-AD (NAD) participants in clinical routine of memory centers.Methods: Both scales were compared using 904 participants with cognitive impairment recruited from two independent cohorts (Mtp-1 and Mtp-2). The CSF Aβ42/Aβ40 ratio was measured systematically in Mtp-1, and only on biologically discordant cases in Mtp-2. Two different ELISA kit providers were also employed. The distribution of AD and NAD patients and the discrepancies of biomarker profiles were computed. Receiver Operating Characteristic curves were used to represent clinical sensitivity and specificity for AD detection. The classification of patients with the net reclassification index (NRI) was also evaluated.Results: Nine hundred and four participants (342 AD and 562 NAD) were studied; 400 in Mtp-1 and 504 in Mtp-2. For AD patients, the mean CSF Aβ42 and CSF Aβ42/40 ratio was 553 ± 216 pg/mL and 0.069 ± 0.022 pg/mL in Mtp-1 and 702 ± 335 pg/mL and 0.045 ± 0.020 pg/mL in Mtp-2. The distribution of AD and NAD differed between the PLM and the PLMR scales (p < 0.0001). The percentage AD well-classified (class 3) increased with PLMR from 38 to 83% in Mpt-1 and from 33 to 53% in Mpt-2. A sharp reduction of the discordant profiles going from 34 to 16.3% and from 37.5 to 19.8%, for Mtp-1 and Mtp-2 respectively, was also observed. The AUC of the PLMR scale was 0.94 in Mtp-1 and 0.87 in Mtp-2. In both cohorts, the PLMR outperformed CSF Aβ42 or Aβ42/40 ratio. The diagnostic performance was improved with the PLMR with an NRI equal to 44.3% in Mtp-1 and 28.8% in Mtp-2.Conclusion: The integration of the Aβ42/Aβ40 ratio in the PLMR scale resulted in an easy-to-use tool which reduced the discrepancies in biologically doubtful cases and increased the confidence in the diagnosis in memory center.

Background: Cerebrospinal fluid (CSF) biomarkers (Ab peptides and tau proteins) improved the diagnosis of Alzheimer's disease (AD) in research and clinical settings. We previously described the PLM-scale (Paris-Lille-Montpellier study), which combines Ab42, tau, and phosphorylated ptau(181) biomarkers in an easy to use and clinically relevant way. The purpose of this work is to evaluate an optimized PLMR-scale (PLM ratio scale) that now includes the Ab42/Ab40 ratio to detect AD versus non-AD (NAD) participants in clinical routine of memory centers. Methods: Both scales were compared using 904 participants with cognitive impairment recruited from two independent cohorts (Mtp-1 and Mtp-2). The CSF Ab42/Ab40 ratio was measured systematically in Mtp-1, and only on biologically discordant cases in Mtp-2. Two different ELISA kit providers were also employed. The distribution of AD and NAD patients and the discrepancies of biomarker profiles were computed. Receiver Operating Characteristic curves were used to represent clinical sensitivity and specificity for AD detection. The classification of patients with the net reclassification index (NRI) was also evaluated. Results: Nine hundred and four participants (342 AD and 562 NAD) were studied; 400 in Mtp-1 and 504 in Mtp-2. For AD patients, the mean CSF Ab42 and CSF Ab42/40 ratio was 553 ± 216 pg/mL and 0.069 ± 0.022 pg/mL in Mtp-1 and 702 ± 335 pg/mL and 0.045 ± 0.020 pg/mL in Mtp-2. The distribution of AD and NAD differed between the PLM and the PLMR scales (p < 0.0001). The percentage AD well-classified (class 3) increased with PLMR from 38 to 83% in Mpt-1 and from 33 to 53% in Mpt-2. A sharp reduction of the discordant profiles going from 34 to 16.3% and from 37.5 to 19.8%, for Mtp-1 and Mtp-2 respectively, was also observed. The AUC of the PLMR scale was 0.94 in Mtp-1 and 0.87 in Mtp-2. In both cohorts, the PLMR outperformed CSF Ab42 or Ab42/40 ratio. The diagnostic performance was improved with the PLMR with an NRI equal to 44.3% in Mtp-1 and 28.8% in Mtp-2. Conclusion: The integration of the Ab42/Ab40 ratio in the PLMR scale resulted in an easy-to-use tool which reduced the discrepancies in biologically doubtful cases and increased the confidence in the diagnosis in memory center. [ABSTRACT FROM AUTHOR]

Background: Identifying high-risk groups for posttraumatic stress disorder (PTSD) during evacuation situations requires a valid short screening tool. The re-experiencing symptoms of PTSD are considered helpful for distinguishing those with PTSD from those without, as they are thought to be specific to PTSD, have less ambiguity for respondents, and are representative of all PTSD symptoms. Objective: To develop a new short version of the Posttraumatic Diagnostic Scale (PDS) comprising only re-experiencing symptom items. Method: We used existing data (N = 169) from our previous study on the Japanese version of the PDS and the Clinician-Administered PTSD Scale (CAPS). The sample included both clinical outpatients (n = 106) and university students (n = 63), all of whom reported one or more traumatic experiences. We created candidate 2- and 3-item versions of the PDS and compared their psychometric characteristics against the CAPS. Results: The best candidate (comprising items for ‘intrusive images’, ‘nightmares’, and ‘physiological reactions when reminded of the trauma’) demonstrated an area under the curve of .95, 94.8% sensitivity, 86.1% specificity for the best cut-off score of three. The candidate scale also showed a strong correlation with CAPS-evaluated severity score and internal consistency. Conclusions: The brief re-experiencing PDS had good psychometric properties among Japanese adults with and without PTSD.

Background: On February 27, 2010 (F-27), an earthquake and tsunami occurred having a significant impact on the mental health of the Chilean population, leading to an increase in cases of post-traumatic stress disorder (PTSD). Objectives: Within this context, validated for the first time in Chile was the Davidson Trauma Scale (DTS) using three samples (each one consisting of 200 participants), two of them random from the Chilean population. Results: Reliability analyses (i.e., α=0.933), concurrent validity (63% of the items are significantly correlated with the criteria variable “degree of damage to home”) and construct validity (i.e., CMIN = 3.754, RMSEA = 0.118, NFI = 0.808, CFI = 0.850 and PNFI = 0.689) indicate validity between regular and good for DTS. However, a new short version of the scale (DTS-SF) created using the items with heavier factor weights, presented better fits (CMIN = 2.170, RMSEA = 0.077, NFI = 0.935, CFI = 0.963, PNFI = 0.697). Discussion: Finally, the usefulness of DTS and DTS-SF is discussed, the latter being briefer, valid and having better psychometric characteristics.

The Kessler 10 (K10) and embedded Kessler 6 (K6) was developed to screen for non-specific psychological distress and serious mental illness in mental health surveys of English-speaking populations, but has been adopted in Western and non-Western countries as a screening and outcome measure in primary care and mental health settings. This review examines whether the original K6/K10's validity for culturally diverse populations was established, and whether the cultural equivalence, and sensitivity to change of translated or culturally adapted K6/K10s, has been demonstrated with culturally diverse client groups. Evidence for the original K6/K10's validity for culturally diverse populations is limited. Questions about the conceptual and linguistic equivalence of translated/adapted K6/K10s arise from reports of changes in item connotation and differential item functioning. Evidence for structural equivalence is inconsistent, as is support for criterion equivalence, with the majority of studies compromising on accuracy in case prediction. Research demonstrating sensitivity to change with culturally diverse groups is lacking. Inconsistent evidence for the K6/K10's cultural appropriateness in clinical settings, and a lack of clinical norms for either majority or culturally diverse groups, indicate the importance of further research into the psychological distress construct with culturally diverse clients, and the need for caution in interpreting K6/K10 scores. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

El objetivo del presente trabajo fue realizar la adaptación argentina de la Escala de Malestar Psicológico de Kessler (Kessler Psychological Distress Scale-K10). Para esto, se llevó a cabo una adaptación lingüística del instrumento y un análisis de sus propiedades psicométricas. Para evaluar la confiabilidad de la escala, se efectuó un análisis de la consistencia interna y se examinó la estabilidad temporal de los ítems. La validez del instrumento fue evaluada teniendo en consideración diferentes indicadores de la misma. Se calcularon, a través de las curvas ROC, los niveles de sensibilidad, especificidad y el área bajo la curva (ABC) de la prueba. Los resultados indican que se puede contar con la K10 como un instrumento de despistaje de malestar psicológico que reúne los requisitos psicométricos necesarios para ser utilizado en población argentina.

On February 27, 2010 (F-27), an earthquake and tsunami occurred having a significant impact on the mental health of the Chilean population, leading to an increase in cases of post-traumatic stress disorder (PTSD). Within this context, validated for the first time in Chile was the Davidson Trauma Scale (DTS) using three samples (each one consisting of 200 participants), two of them random from the Chilean population. Reliability analyses (i.e., α=0.933), concurrent validity (63% of the items are significantly correlated with the criteria variable "degree of damage to home") and construct validity (i.e., CMIN = 3.754, RMSEA = 0.118, NFI = 0.808, CFI = 0.850 and PNFI = 0.689) indicate validity between regular and good for DTS. However, a new short version of the scale (DTS-SF) created using the items with heavier factor weights, presented better fits (CMIN = 2.170, RMSEA = 0.077, NFI = 0.935, CFI = 0.963, PNFI = 0.697). Finally, the usefulness of DTS and DTS-SF is discussed, the latter being briefer, valid and having better psychometric characteristics. [ABSTRACT FROM AUTHOR]

Background: Screening scales for bipolar disorder including the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) have been plagued by high false positive rates confounded by presence of borderline personality disorder. This study examined the accuracy of these scales for detecting bipolar disorder among patients referred for eating disorders and explored the possibility of simultaneous assessment of co-morbid borderline personality disorder. Methods: Participants were 78 consecutive female patients who were referred for evaluation of an eating disorder. All participants completed the mood and eating disorder sections of the SCID-I/P and the borderline personality disorder section of the SCID-II, in addition to the MDQ and BSDS. Predictive validity of the MDQ and BSDS was evaluated by Receiver Operating Characteristic analysis of the Area Under the Curve (AUC). Results: Fifteen (19%) and twelve (15%) patients fulfilled criteria for bipolar II disorder and borderline personality disorder, respectively. The AUCs for bipolar II disorder were 0.78 (MDQ) and 0.78 (BDSD), and the AUCs for borderline personality disorder were 0.75 (MDQ) and 0.79 (BSDS). Conclusions: Among patients being evaluated for eating disorders, the MDQ and BSDS show promise as screening questionnaires for both bipolar disorder and borderline personality disorder. [ABSTRACT FROM AUTHOR]

Background: Identifying high-risk groups for posttraumatic stress disorder (PTSD) during evacuation situations requires a valid short screening tool. The re-experiencing symptoms of PTSD are considered helpful for distinguishing those with PTSD from those without, as they are thought to be specific to PTSD, have less ambiguity for respondents, and are representative of all PTSD symptoms. Objective: To develop a new short version of the Posttraumatic Diagnostic Scale (PDS) comprising only re-experiencing symptom items. Method: We used existing data (N =169) from our previous study on the Japanese version of the PDS and the Clinician-Administered PTSD Scale (CAPS). The sample included both clinical outpatients (n =106) and university students (n =63), all of whom reported one or more traumatic experiences. We created candidate 2- and 3-item versions of the PDS and compared their psychometric characteristics against the CAPS. Results: The best candidate (comprising items for ‘intrusive images’, ‘nightmares’, and ‘physiological reactions when reminded of the trauma’) demonstrated an area under the curve of .95, 94.8% sensitivity, 86.1% specificity for the best cut-off score of three. The candidate scale also showed a strong correlation with CAPS-evaluated severity score and internal consistency. Conclusions: The brief re-experiencing PDS had good psychometric properties among Japanese adults with and without PTSD. 题目：新的简版创伤后诊断量表：在患有和未患有PTSD的日本成年群体中的验证 背景：在疏散情景下识别高风险的创伤后应激障碍（PTSD）群体需要一个有效简短的筛选工具。PTSD的再体验症状具有PTSD特异性、对应答者具有较少歧义、对所有PTSD症状有代表性，因此被认为有助于区分患有PTSD和未患有的人群。 目标：开发一个只包含再体验症状题目的新的简版创伤后诊断量表（PDS）。 方法：我们使用之前关于日本版PDS和临床诊断PTSD量表（CAPS）的研究中的现有数据（N=169）。样本中既有临床门诊病人（n=106）也有大学学生(n=69)，他们都报告了一个或以上创伤性经历。我们开发了2个题目和3个题目的备选PDS，并将它们的心理测量特性和CAPS进行对比。 结果：最好的备选量表（包括“闯入性图像”,”噩梦”,”被提醒创伤时的生理反应”）显示出了.95的曲线下面积（area under the curve），最好的划界分（3分）具有94.8%的敏感性和86.1%的特异性。备选量表也表现出了和CAPS症状验证分数的强相关，以及内部一致性。 结论：简版在体验PDS在患有和未患有PTSD的日本成年群体中有很好的心理测量特性。 关键词：创伤后应激障碍，筛选量表，验证，创伤后诊断量表，心理测量特性，再体验症状 [ABSTRACT FROM AUTHOR]

Background: Cerebrospinal fluid (CSF) biomarkers (Aβ peptides and tau proteins) improved the diagnosis of Alzheimer's disease (AD) in research and clinical settings. We previously described the PLM-scale (Paris-Lille-Montpellier study), which combines Aβ42, tau, and phosphorylated ptau(181) biomarkers in an easy to use and clinically relevant way. The purpose of this work is to evaluate an optimized PLM R- scale (PLM ratio scale) that now includes the Aβ42/Aβ40 ratio to detect AD versus non-AD (NAD) participants in clinical routine of memory centers. Methods: Both scales were compared using 904 participants with cognitive impairment recruited from two independent cohorts (Mtp-1 and Mtp-2). The CSF Aβ42/Aβ40 ratio was measured systematically in Mtp-1, and only on biologically discordant cases in Mtp-2. Two different ELISA kit providers were also employed. The distribution of AD and NAD patients and the discrepancies of biomarker profiles were computed. Receiver Operating Characteristic curves were used to represent clinical sensitivity and specificity for AD detection. The classification of patients with the net reclassification index (NRI) was also evaluated. Results: Nine hundred and four participants (342 AD and 562 NAD) were studied; 400 in Mtp-1 and 504 in Mtp-2. For AD patients, the mean CSF Aβ42 and CSF Aβ42/40 ratio was 553 ± 216 pg/mL and 0.069 ± 0.022 pg/mL in Mtp-1 and 702 ± 335 pg/mL and 0.045 ± 0.020 pg/mL in Mtp-2. The distribution of AD and NAD differed between the PLM and the PLM R scales ( p < 0.0001). The percentage AD well-classified (class 3) increased with PLM R from 38 to 83% in Mpt-1 and from 33 to 53% in Mpt-2. A sharp reduction of the discordant profiles going from 34 to 16.3% and from 37.5 to 19.8%, for Mtp-1 and Mtp-2 respectively, was also observed. The AUC of the PLM R scale was 0.94 in Mtp-1 and 0.87 in Mtp-2. In both cohorts, the PLM R outperformed CSF Aβ42 or Aβ42/40 ratio. The diagnostic performance was improved with the PLM R with an NRI equal to 44.3% in Mtp-1 and 28.8% in Mtp-2. Conclusion: The integration of the Aβ42/Aβ40 ratio in the PLM R scale resulted in an easy-to-use tool which reduced the discrepancies in biologically doubtful cases and increased the confidence in the diagnosis in memory center.