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BMJ Open. 2019 Mar 3;9(3):e026468. doi: 10.1136/bmjopen-2018-026468.

Ethical and social implications of using predictive modeling for Alzheimer's disease prevention: a systematic literature review protocol.

Author information

Analytica Laser, a Certara Company, Loerrach, Germany.
LA-SER Core, Paris, France.
CESP, INSERM U1178, Paris, France.
Oxford Internet Institute, University of Oxford, Oxford, UK.
Alzheimer Europe, Luxembourg, Luxembourg.
Janssen Pharmaceutica NV, Titusville, NJ, USA.
Novartis Pharma AG, Basel, Basel-Stadt, Switzerland.



The therapeutic paradigm in Alzheimer's disease (AD) has shifted towards secondary prevention, defined as an intervention aiming to prevent or delay disease onset in pre-symptomatic individuals at risk of developing dementia due to AD. The key feature of AD prevention is the need to treat years or even decades before the onset of cognitive, behavioural or functional decline. Prediction of AD risk and evaluation of long-term treatment outcomes in this setting requires predictive modelling and is associated with ethical concerns and social implications. The objective of this review is to identify and elucidate them, as presented in the literature.


A systematic literature review was conducted in Medline, Embase, PsycInfo and Scopus, and was complemented with a grey literature search. All searches were conducted between March and July 2018. Two reviewers independently assessed each study for inclusion and disagreements were adjudicated by a third reviewer. Data are now being extracted using an extraction sheet developed within the group of reviewers, based on an initial sample of three manuscripts, but allowing for inclusion of newly identified data items (ethical arguments). Data will be analysed qualitatively using a thematic analysis technique. Potential biases in selection and interpretation of extracted data are mitigated by the fact that reviewers come from a range of different scientific backgrounds and represent different types of stakeholders in this ethical discussion (academia, industry, patient advocacy groups).


The study does not require ethical approval. The findings of the review will be disseminated in a peer-reviewed journal and presented at conferences. They will also be reported through the Innovative Medicine Initiative project: Real World Outcomes Across the AD Spectrum for Better Care: Multi-modal Data Access Platform (IMI: ROADMAP).




dementia; early intervention; elsi; qualitative research; slr

Conflict of interest statement

Competing interests: This SLR is being conducted as part of the ROADMAP project. ROADMAP is a consortium of academic, public sector and industry partners working collaboratively within the European Union Innovative Medicines Initiative framework. ZA, HK, CN, JS and MN are employees of Analytica Laser which received consulting fees from Novartis and other pharmaceutical companies. DG is an employee of Alzheimer Europe. FdRdV is employee of Novartis Pharma AG. AK is employee of Janssen Pharmaceutica NV.

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