Table 2.
Overview of theoretical arguments in favor or against amyloid positron emission tomography (PET) result disclosure
Cognitively normal | Mild cognitive impairment | ||||
---|---|---|---|---|---|
Category | Arguments | Research | Clinic | Research | Clinic |
Pro | |||||
Ethical | Patient autonomy | X10,41 | X10,41 | X39 | X5 |
Evidence of non-maleficence | X10,40,41 | X10,40,41 | |||
Social and legal | Cost and suffering reduction | X38 | X38 | ||
Favors Alzheimer’s disease prevention | X10 | X10 | |||
Psychological and behavioral | Enables early decision making | X10,38,41 | X10,38,41 | X39 | X5 |
Clarifying effect of correct diagnosis | X38 | X38 | X39 | X5 | |
Relief related to negative amyloid PET | X38,41 | X38,41 | |||
Satisfies need for risk information | X41 | X41 | |||
PET imaging characteristics | Amyloid PET imaging is validated | X39 | |||
Clinical significance of amyloid PET | X5 | ||||
Contra | |||||
Ethical | Non-maleficence | X10,38,41 | X10,38,41 | X39 | X5 |
Lack of effective intervention | X10,38 | X10,38 | X39 | ||
Therapeutic misconception | X2 | X2 | |||
Social and legal | Unwanted personal implications | X38,41 | X10,38,41 | X5 | |
Social stigmatization | X38,41 | X38,41 | |||
Psychological and behavioral | Risk of psychological distress | X10,38,41 | X10,38,41 | X5 | |
Risk of false reassurance after negative PET | X10,41 | X10,41 | X39 | ||
Misinterpretation of positive amyloid PET | X41 | X41 | |||
PET imaging characteristics | Challenges related to inconclusive scans | X10,38 | X10,38 | X5 | |
Limited predictive value at level of individual | X10,41 | X10,41 | |||
Variation on interpretation of PET results | X10 | X10 |