Referring Physician

The New IDEAS study is currently reaching out to dementia specialists in areas identified by our community engagement and recruitment team. If you have not been contacted yet and would like to be considered for inclusion in the study, please send an email to newideas@acr.org.

Participation in New IDEAS requires the submission of a site feasibility questionnaire and subsequent approval by the study. Information about the New IDEAS study will also be disseminated via professional organizations dedicated to neurology, psychiatry, geriatrics, nuclear medicine and radiology.

Access the feasibility questionnaire for referring dementia sites.

We define a dementia specialist as a self-identified physician, trained and board certified in neurology, psychiatry or geriatric medicine, who devotes a substantial proportion (≥25%) of patient contact time to the evaluation and care of adults with acquired cognitive impairment or dementia. The study team will verify qualifications during the site feasibility and site registration processes.

Establishing the cause of cognitive impairment is necessary for doctors to make appropriate recommendations, prescribe the correct treatments, and inform patients and families about what to expect in the future. The best way to establish the cause of cognitive impairment is a thorough clinical assessment by a dementia expert, an evaluation that typically includes blood tests and a brain CT or MRI scan.

However, in some cases the diagnosis remains uncertain after such an evaluation, and further knowledge about the presence or absence of brain amyloid could provide valuable additional information. In some cases, a positive amyloid PET scan may confirm the clinical suspicion of Alzheimer’s disease. In such cases, establishing the diagnosis will help doctors initiate medications approved for the treatment of the disease. Furthermore, doctors will be able to make informed recommendations about the safety of continued employment, driving and independent living — now and in the future.

Patients and caregivers can be referred to the Alzheimer’s Association and other community resources to provide support and assist with future planning.

Studies suggest that, even in lieu of a cure or disease-modifying therapy, most patients seeking a clinical assessment for their cognitive symptoms want to know if the doctor suspects Alzheimer’s disease. Providing patients with the best possible diagnosis adheres to core principles of medical ethics, such as patient autonomy, truth telling, and lack of paternalism.

In other cases, a negative amyloid PET scan would render the diagnosis of Alzheimer’s disease unlikely. This might lead to the diagnosis of an alternative cause of dementia, which may have a different trajectory, prognosis and treatment plan. Doctors would elect to avoid prescribing or discontinue drugs that are effective in Alzheimer’s disease but may be ineffective and potentially even harmful to patients with a different dementia. In some cases, a negative amyloid PET scan might help doctors determine that cognitive impairment is due to a medical condition, mood or sleep disorder, or medication side effect — dramatically altering the prognosis and care plan.

Before enrolling in the New IDEAS study, patients and their doctors should discuss the ramifications of amyloid PET testing and carefully consider how a positive or negative amyloid PET result will impact the care plan as well as the patient’s overall well-being. The scan should not be pursued if it is felt that knowledge of amyloid status will cause significant psychological harm or otherwise negatively impact the patient and family.

Clinical amyloid PET imaging via the New IDEAS study is not appropriate for cognitively normal individuals (and is not a covered service for Medicare beneficiaries).

Disclosure of the PET scan result and subsequent management recommendations need not wait for the post-PET visit. We hope that clinicians will provide feedback to patients and their families shortly after the scan is read. The post-PET visit then records the patient management implemented by the patient/family.

Two visits are recommended:

1. Clinical visit to provide feedback on scan results (not mandated in study protocol but recommended based on best practices of providing timely feedback, preferred in person). This can be considered time point #4, but it is not a study-related visit and no data collection is required.
2. 90 day post-PET visit (mandated in study protocol). The post-PET form is completed at 90 days, not immediately post-PET, in order to record actual implemented management, as opposed to the intended management recommended immediately post-PET but not yet implemented.

To put it in concrete terms: we want to record the actual implemented management at the 90 days post-PET timepoint (e.g., whether someone who was at baseline medication-naïve is actually on a medication), rather than whether it was recommended immediately after the scan (intended management).

Yes, the protocol allows for telemedicine platforms to be used for the pre-PET and post-PET visits. You will be asked to document the communication methodology via the case report forms of the visits.

No. The same physician must submit both the pre- and post-PET clinical assessment forms. If this is not possible, the post-PET form for that case cannot be submitted. If the scan has not been completed, the patient can be re-registered and conduct another pre-PET visit. If the scan has already been completed, that patient's case must be terminated within the study database.

Amyloid PET scans in the New IDEAS study will be interpreted by trained readers at the local PET facilities. To be eligible to interpret PET scans in the New IDEAS study, physicians must be board certified in radiology or nuclear medicine and must demonstrate that they have completed the tracer-specific training program provided for each radiopharmaceutical they plan to use. Local PET facilities must also apply via feasibility questionnaire and obtain approval by the study to register.

Access the feasibility questionnaire for PET imaging facilities.

The dementia specialist practice will receive a total of $500 for a complete case. The site will receive $250 for submitting the pre-PET case report form and an additional $250 for the post-PET case report form. These case report forms will be submitted online; you may view them on the New IDEAS study website. Payments will be made monthly via Bank of America to a specific entity via a bank routing number/account. Banking information is collected via the study’s encrypted and secure database.

Veterans Affairs and military hospitals may not participate. The only other restriction is that the radiopharmaceutical must be available in that state.

The site does not have a responsibility to collect or ship the biospecimens. However, sites have a responsibility to consent the participant properly, answer any questions the participant may have about sample collection, and record the consent decision within the study database.

All registered participants will receive a saliva collection kit in the mail with instructions on how to collect the saliva and ship the sample back via mail. Participants who also consent to the optional blood collection will be sent a collection kit in the mail with instructions to visit their local Quest Diagnostics laboratory to have their blood drawn. Quest will handle collection and shipment of the sample.