- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07200739
- Original Trial
Speech-Based Artificial Intelligence for Detection of Dementia in Danish Patients (DetectAI) (DetectAI)
Development of Deep Learning Models for Detection of Neurodegenerative Diseases Using Speech - a Danish Language-based Artificial Intelligence Study (DetectAI)
The goal of this observational study is to learn if an artificial intelligence (AI)-based speech analysis tool can identify which patients with memory problems need specialist evaluation at a memory clinic. The main questions it aims to answer are:
Can the AI model accurately distinguish between patients who need referral to a memory clinic (those with dementia or Mild Cognitive Impairment) and patients who don't (those with normal cognition or memory problems from other causes like depression)? Which speech patterns and cognitive test features are most useful for making this distinction?
Researchers will compare speech recordings and cognitive test results from patients diagnosed with dementia or MCI to those from patients with normal cognition or non-neurodegenerative cognitive impairment to see if the AI model can reliably predict who needs specialist dementia care.
Participants will:
Complete standard cognitive tests at the memory clinic Perform structured speech tasks while being audio-recorded Receive their usual clinical evaluation and diagnosis from memory clinic specialists
The results of this study will help develop a tool that can assist doctors in making faster, more accurate decisions about which patients need specialist dementia evaluation, potentially leading to earlier diagnosis and better patient outcomes.
Study Overview
Status
Conditions
Intervention / Treatment
- Diagnostic test: Mini-mental State Examination
- Diagnostic test: Addenbrooke's Cognitive Examination
- Other: Speech Task - Picture Description
- Other: Speech Task - Picture Recall
- Diagnostic test: MRI
- Diagnostic test: blood sampling
- Diagnostic test: Depression screening
- Other: Somatic- and neurological examination
- Other: Speech Task - Picture Narrative
Detailed Description
Background Dementia is a growing public health challenge, and early and accurate diagnosis is essential for effective care and potential future disease-modifying treatments. Current diagnostic pathways are resource-intensive and associated with long waiting times. Speech reflects cognitive functioning, and recent international studies have shown that machine learning models can detect dementia-related patterns in speech recordings with promising accuracy. This study aims to develop a speech-based deep learning model in a Danish setting, providing a non-invasive and scalable screening tool for use in primary care.
Study Design and Sampling Methods
This is an observational, cross-sectional study. Participants are recruited using two different sampling strategies corresponding to two artificial intelligence (AI) model development tracks:
Track A (Model A) - Retrospective case-control sampling:
This track addresses a focused diagnostic task: identification of Mild Cognitive Impairment (MCI). Participants are patients with a recent diagnosis from the memory clinic at Region Zealand University Hospital (ZUH). Sampling uses convenience sampling prioritizing patients who live close to the hospital, as data collection occurs during home visits. Patients with more recent diagnoses are prioritized to minimize the risk that participants have progressed to a new disease stage since diagnosis (e.g., from MCI to dementia).
Track B (Model B) - Prospective consecutive sampling:
This track uses prospective inclusion of newly referred patients to the memory clinic without pre-selection by diagnosis, reflecting a real-world clinical screening population. All eligible, consenting patients are included consecutively at their first clinic visit, before final diagnosis is established.
Model Development Following Best Practice Guidelines The study follows TRIPOD-AI (Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis - Artificial Intelligence) and PROBAST-AI (Prediction model Risk Of Bias ASsessment Tool - Artificial Intelligence) guidelines for developing and validating clinical prediction models.
Key methodological features include:
Transparent model development: All preprocessing steps, feature extraction methods, model architectures, and hyperparameters will be documented Robust validation strategy: Data will be split into training, validation, and hold-out test sets for in-depth internal validation.
Minimizing bias: Participant selection, predictor measurement, outcome determination, and statistical analysis are designed to minimize bias according to PROBAST-AI domains Clinically relevant performance metrics: Sensitivity, specificity, area under the receiver operating characteristic curve (AUC-ROC), positive and negative predictive values, and calibration Interpretability: Feature importance analysis to understand which speech characteristics contribute to predictions
Data Collection Speech data is collected through structured tasks including picture description, verbal fluency tests, story recall, and spontaneous speech. Audio is recorded using standardized equipment with quality control checks. Clinical diagnoses are established by experienced clinicians at the memory clinic following international diagnostic criteria.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Sofie J Vængebjerg, MD
- Phone Number: +4530294621
- Email: sova@regsj.dk
Study Contact Backup
- Name: Peter Høgh, MD, PhD, Assoc Prof
- Phone Number: +45 22526698
- Email: phh@regionsjaelland.dk
Study Locations
-
-
Region Sjælland
-
Roskilde, Region Sjælland, Denmark, 4000
- Zealand University Hospital
-
Contact:
- Sofie J Vængebjerg, MD, PhD student
- Phone Number: +45 30294621
- Email: sova@regsj.dk
-
Contact:
- Peter Høgh, MD, PhD, Assoc Prof
- Email: phh@regionsjaelland.dk
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
Model A (patient participants)
- Age > 50 years
- Fluent in Danish
- Minimum of 7 years of schooling
- A diagnosis of either MCI or AD, given at the SUH memory clinic within 6 months before enrollment
Model A (cognitively healthy controls)
- Age > 50 years
- Fluent in Danish
- Minimum of 7 years of schooling
Model B:
- Age > 50 years
- Fluent in Danish
- Minimum of 7 years of schooling
Exclusion Criteria:
Model A:
Patients:
- Significantly impaired vision or hearing (to the extent that the patient cannot participate in the AI analysis)
- MMSE score < 16
- Concomitant diagnoses which are expected to influence cognitive impairment (eg. depression)
- Patients unable to give consent
- Patients with alcohol consumption >21 standard alcohol units per week
- Any history of speech or language impairment predating the current condition
Cognitively healthy controls:
- Significantly impaired vision or hearing (to the extent that the patient cannot participate in the AI analysis)
- MMSE < 26 and ACE < 90
- Clinical, laboratory, or neuroradiological findings that could affect cognitive functions
- Known diseases which are expected to impair cognitive functions
- Any history of speech or language impairment predating the current condition
- Patients with alcohol consumption >21 standard alcohol units per week.
Model B:
- Significantly impaired vision or hearing (to the extent that the patient cannot participate in the AI analysis)
- MMSE score < 16
- Patients unable to give consent
- Patients with concomitant psychosis or severe psychiatric comorbidities other than depression
- Any history of speech or language impairment predating the current condition
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
|---|---|
|
Cognitively Healthy Control Participants for Model A
We seek to enroll 40 age-matched cognitively healthy control participants for the training of model A.
|
Participants will be recorded during the test in order til allow the AI to learn and analyze speech patterns.
Other Names:
Participants will be recorded during the test in order til allow the AI to learn and analyze speech patterns.
Other Names:
Participants will be asked to describe the Cookie Theft Picture from the Boston Diagnostic Aphasia Examination.
The task will take 2 minutes.
Participants will be recorded during the speech task in order to allow the AI to learn and analyze the speech patterns.
Participants will be asked to recall the picture shown in the previous speech task "Picture Narrative".
This task will take 2 minutes.
Participants will be recorded during the test in order til allow the AI to learn and analyze speech patterns.
For healthy controls an MRI will be conducted to provide comparable imaging and as part of screening to ensure they do not meet exclusion criteria (neuroradiological findings that could affect cognitive functions). For patient participants, imaging will be performed as part of the standard diagnostic battery and results will be obtained from the electronic journal. Healthy control participants will undergo a standard blood test panel commonly used in dementia diagnostics. The panel includes complete blood counts, inflammatory markers, kidney- and liver function markers, thyroid-stimulating hormone (TSH), vitamine B12 and folate. These tests are performed to exclude underlying medical conditions that could mimic cognitive impairment. For patient participants, blood sampling will be performed as part of the standard diagnostic battery and results will be obtained from the electronic journal. Performed on healthy controls to rule out depression using either the geriatric depression scale (GDS) for patients > 65 year of age or the Major Depression Index (MDI) for patiens <65 year of age. For patient participants, depression screening will be performed as part of the standard diagnostic battery and results will be obtained from the electronic journal. Healthy controls will undergo a standard somatic and neurological examination to exclude conditions that may affect cognition. This includes basic neurological assessment and clinical evaluation of general health status. For patient participants, a somatic and neurological examination will be performed as part of the standard diagnostic battery and results will be obtained from the electronic journal
The participant is asked to tell a brief story based on a culturally neutral picture.
This task will take approximately 2 minutes.
Participants will be recorded during the speech task in order to allow the AI to learn and analyze the speech patterns
|
|
Patient Participants for Model A
We seek to retrospectively enroll patients from the ZUH memory clinic with a diagnosis of either Alzheimer's Disease (AD, n=50) or MCI (n=50), made within 6 months prior to enrollment.
These participants will be used for the training of model A.
|
Participants will be recorded during the test in order til allow the AI to learn and analyze speech patterns.
Other Names:
Participants will be recorded during the test in order til allow the AI to learn and analyze speech patterns.
Other Names:
Participants will be asked to describe the Cookie Theft Picture from the Boston Diagnostic Aphasia Examination.
The task will take 2 minutes.
Participants will be recorded during the speech task in order to allow the AI to learn and analyze the speech patterns.
Participants will be asked to recall the picture shown in the previous speech task "Picture Narrative".
This task will take 2 minutes.
Participants will be recorded during the test in order til allow the AI to learn and analyze speech patterns.
The participant is asked to tell a brief story based on a culturally neutral picture.
This task will take approximately 2 minutes.
Participants will be recorded during the speech task in order to allow the AI to learn and analyze the speech patterns
|
|
Patient Participants for Model B
We will prospectively recruit newly referred patients for the memory clinic at ZUH. Enrollment happens at first patient visit.
At this time, diagnosis is not yet known, but assumed present.
|
Participants will be recorded during the test in order til allow the AI to learn and analyze speech patterns.
Other Names:
Participants will be recorded during the test in order til allow the AI to learn and analyze speech patterns.
Other Names:
Participants will be asked to describe the Cookie Theft Picture from the Boston Diagnostic Aphasia Examination.
The task will take 2 minutes.
Participants will be recorded during the speech task in order to allow the AI to learn and analyze the speech patterns.
Participants will be asked to recall the picture shown in the previous speech task "Picture Narrative".
This task will take 2 minutes.
Participants will be recorded during the test in order til allow the AI to learn and analyze speech patterns.
The participant is asked to tell a brief story based on a culturally neutral picture.
This task will take approximately 2 minutes.
Participants will be recorded during the speech task in order to allow the AI to learn and analyze the speech patterns
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Model A: Primary measure is the AUC-ROC of the model in distinguishing between MCI and AD as well as between MCI and cognitively healthy control participants.
Time Frame: At baseline (speech recording)
|
We will measure the AUR-ROC of AI predictions compared to clinical consensus diagnosis. Metrics will be presented including uncertainty estimates. Model performance will be measured on an independent test-set consisting of patients from the model B training population. |
At baseline (speech recording)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Accuracy for dementia vs. depression
Time Frame: At baseline (speech recording)
|
Measured by sensitivity, specificity, AUR-ROC of AI predictions compared to clinical consensus diagnosis, using baseline speech recordings from participants.
Model performance will be measured after database lock at study completion.
|
At baseline (speech recording)
|
|
Sub-classification of Mild Cognitive Impairment (MCI) into progressive vs. non-progressive
Time Frame: At baseline (speech recording) and up to 12 months after enrollment (to determine progression)
|
Measured by sensitivity, specificity, AUR-ROC of AI predictions compared to clinical consensus diagnosis, using baseline speech recordings from participants. Model performance will be measured after database lock at study completion. Progression is defined as new dementia diagnosis during study period. |
At baseline (speech recording) and up to 12 months after enrollment (to determine progression)
|
|
Classification of dementia subtypes (AD, VaD, LBD, FTD)
Time Frame: At baseline (speech recording)
|
Measured by sensitivity, specificity, AUR-ROC of AI predictions compared to clinical consensus diagnosis, using baseline speech recordings from participants.
Model performance will be measured after database lock at study completion.
|
At baseline (speech recording)
|
|
Comparison with established biomarkers
Time Frame: At baseline, or at time of biomarker testing if performed after baseline
|
Differences in diagnostic accuracy between AI predictions and state-of-the-art biomarkers for dementia diagnosis
|
At baseline, or at time of biomarker testing if performed after baseline
|
|
Feature importance analysis
Time Frame: At baseline (speech recording)
|
Feature importance will be evaluated using interpretability analyses (e.g.
permutation importance, SHAP values, and/or ablation of feature groups) to quantify the contribution of acoustic and linguistic features to the model's predictions.
|
At baseline (speech recording)
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of tasks required for optimal accuracy
Time Frame: At baseline (speech recording)
|
Evaluation of whether a reduced set of speech tasks provide accuracy comparable to the full test battery.
|
At baseline (speech recording)
|
|
Contribution of individual speech tasks to AI model performance
Time Frame: At baseline (speech recording)
|
Contribution of individual speech tasks will be evaluated by comparing model performance (e.g.
accuracy, sensitivity, specificity, AUC-ROC) when trained and tested on subsets of speech tasks (memory tests, story recall, picture description).
This will identify which tasks provide the strongest diagnostic signal.
|
At baseline (speech recording)
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Peter Høgh, MD, PhD, Assoc Prof, Zealand University Hospital
Publications and helpful links
General Publications
- Nicholas LE, Brookshire RH. A system for quantifying the informativeness and efficiency of the connected speech of adults with aphasia. J Speech Hear Res. 1993 Apr;36(2):338-50. doi: 10.1044/jshr.3602.338.
- Buderer NM. Statistical methodology: I. Incorporating the prevalence of disease into the sample size calculation for sensitivity and specificity. Acad Emerg Med. 1996 Sep;3(9):895-900. doi: 10.1111/j.1553-2712.1996.tb03538.x.
- Dargaud L, Partal A, Birn A, & Detlefsen S. N. (2023). Developing a Spontaneous Speech-based Artificial Intelligence for Alzheimer's Disease Detection. Transatlantic Telehealth Research Network (TTRN) International Scientific Conference 2023, Journal of the International Society for Telemedicine and eHealth.
- Lanzi AM, Saylor AK, Fromm D, Liu H, MacWhinney B, Cohen ML. DementiaBank: Theoretical Rationale, Protocol, and Illustrative Analyses. Am J Speech Lang Pathol. 2023 Mar 9;32(2):426-438. doi: 10.1044/2022_AJSLP-22-00281. Epub 2023 Feb 15.
- Li J, Song K, Zheng B, Li D, Wu X, Meng H. Leveraging Pretrained Representations with Task-related Keywords for Alzheimer's Disease Detection. arXiv preprint. 2023.
- Luz S, Haider F, de la Fuente Garcia S, Fromm D, MacWhinney B. Detecting cognitive decline using speech only: The ADReSSo challenge. arXiv preprint 2021.
- Luz S, Haider F, Fromm D, Lazarou I, Kompatsiaris I, Macwhinney B. An Overview of the ADReSS-M Signal Processing Grand Challenge on Multilingual Alzheimer's Dementia Recognition Through Spontaneous Speech. IEEE Open J Signal Process. 2024;5:738-749. doi: 10.1109/ojsp.2024.3378595. Epub 2024 Mar 18.
- Bex T. Comprehensive Guide to Multiclass Classification With Sklearn. Towards Data Science. 2021.
- Chen J, Ye J, Tang F, Zhou J. Automatic Detection of Alzheimer's Disease Using Spontaneous Speech Only. Interspeech. 2021 Aug-Sep;2021:3830-3834. doi: 10.21437/interspeech.2021-2002.
- Agbavor F, Liang H. Predicting dementia from spontaneous speech using large language models. PLOS Digit Health. 2022 Dec 22;1(12):e0000168. doi: 10.1371/journal.pdig.0000168. eCollection 2022 Dec.
- de la Fuente Garcia S, Ritchie CW, Luz S. Artificial Intelligence, Speech, and Language Processing Approaches to Monitoring Alzheimer's Disease: A Systematic Review. J Alzheimers Dis. 2020;78(4):1547-1574. doi: 10.3233/JAD-200888.
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
- machine learning
- dementia
- Cognitive Impairment
- stress
- artificial intelligence
- deep learning
- Mild Cognitive Impairment (MCI)
- Frontotemporal Dementia (FTD)
- Lewy Body Dementia (LBD)
- speech-based artificial intelligence
- artificial intelligence in dementia diagnostics
- artificial intelligence for dementia screening
- artificial intelligence for dementia classification
- speech based artificial intelligence
- Vascular dementia (VaD)
- Alzheimer dementia (AD)
- Depression - Major Depressive disorder
- Dementia (diagnosis)
Additional Relevant MeSH Terms
- Synucleinopathies
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Vascular Diseases
- Cardiovascular Diseases
- Mental Disorders
- Pathologic Processes
- Metabolic Diseases
- Neurocognitive Disorders
- Cognition Disorders
- Tauopathies
- Neurodegenerative Diseases
- Movement Disorders
- Parkinsonian Disorders
- Basal Ganglia Diseases
- TDP-43 Proteinopathies
- Proteostasis Deficiencies
- Arteriosclerosis
- Arterial Occlusive Diseases
- Leukoencephalopathies
- Intracranial Arteriosclerosis
- Intracranial Arterial Diseases
- Frontotemporal Lobar Degeneration
- Pathological Conditions, Signs and Symptoms
- Nutritional and Metabolic Diseases
- Cognitive Dysfunction
- Alzheimer Disease
- Disease
- Dementia
- Frontotemporal Dementia
- Dementia, Vascular
- Lewy Body Disease
- Investigative Techniques
- Specimen Handling
- Clinical Laboratory Techniques
- Diagnostic Techniques and Procedures
- Diagnosis
- Punctures
- Surgical Procedures, Operative
- Genetic Phenomena
- Ploidies
- Blood Specimen Collection
- Diploidy
Other Study ID Numbers
- SJ-1107
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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