Observational

Observational

Observational

A detailed analysis of available demographics (age, race, sex, country of birth, insurance status), medications, co-morbidities, and medical history from sites across the US will inform the profile for this patient population. Data from retrospective and prospectively collected medical records will be curated and analyzed to characterize disease natural history and current treatment paradigms. These data may also establish incidence rates of events of special interest. Collection of prospective medical records for each patient enables the continuation of these analyses longitudinally for changes and progression. Part of the characterization of disease or living with a chronic disease may also be informed by patient reported outcome (PRO) measures and care partner surveys.

The study will evaluate the characteristics of patients receiving various treatments, effectiveness of treatment, and medical events that develop while receiving treatment for ADRD, MCI, PD, or MS. Interval disease and medical events may vary depending on the patient's stage and type of disease and extent of co-morbidities. The progression of pre-existing co-morbidities and variances across populations will also be evaluated.

The type, dose and duration of disease-specific therapies will be closely followed with a goal of monitoring treatment paradigms and various combination regimens for clinical response and disease stabilization/progression.

Health care provider type, clinic setting, reason for initiating/not initiating/adjusting dosing of treatments, reason for discontinuing/switching treatments, and monitoring outcomes on and off treatment, will be captured as available in the provided EHR and/or through linked data. Disease-specific quality measures will be selected and evaluated

TARGET-NEURO will enroll an Age Cohort of patients aged 60 years and older, who do not carry a diagnosis code for dementia or mild cognitive impairment. Patients enrolled in this cohort will have their structured and unstructured EHR data routinely screened using the PDM algorithm. 31 Over time, the refreshed data among Age Cohort patients will be screened for a newly presenting dementia diagnosis or mild cognitive impairment code that suggests symptomatic disease and compared with the PDM prediction. Records of those patients will be further evaluated to confirm clinical evidence of disease (positive case) and the patient will continue to be passively followed in the Disease Cohort for outcomes. This exploratory aim enables further validation of the generalizability of the PDM across more health centers and diverse populations.