Multi-platform comparison of plasma phosphorylated tau assays: analytical and workflow factors drive clinical implementation decisions
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Updated: Nov 5, 2026
In Vitro Aggregation Assays Using Hyperphosphorylated Tau Protein
Published on: January 2, 2015
Olga Sandoval-Boczkowska1, John R Best2, Rachael J Y Smith3
1Department of Pathology and Laboratory Medicine University of British Columbia Vancouver Canada.
Introduction:
Multiple plasma phosphorylated tau assays are now commercially available for Alzheimer's disease (AD), yet clinical laboratories lack comprehensive comparative data to guide implementation.
Methods:
We assessed diagnostic accuracy and analytical performance in 273 participants with paired plasma and cerebrospinal fluid (CSF). CSF AD core biomarkers served as the reference standard. Index tests included three plasma tau phosphorylated at residue 217 (pTau217) assays (Roche, Fujirebio, Meso Scale Discovery [MSD]) and a pTau181 assay (Roche).
Results:
Participants: median age 70 [IQR: 64 to 76] years, 42% female, and 60% AD-positive. pTau217 assays showed comparable accuracy (area under the curve [AUC] 0.88 to 0.89) exceeding pTau181 (AUC 0.85). All assays were resistant to hemolysis, icterus, and lipemia. Automated assays (Roche, Fujirebio) showed superior analytical precision and freeze/thaw stability (≥6 cycles) compared to the manual MSD assay (two cycles).
Discussion:
With comparable diagnostic accuracy across pTau217 platforms, analytical performance, and operational suitability became decisive implementation differentiators.