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This commenter encouraged CMS to align measures with existing standards

As of June 2026 there are no completed or registered human clinical trials for FOXO4-DRI

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Although nerve conduction studies or somatosensory evoked potentials can identify abnormalities when the spinal MRI appears normal, their clinical utility in elderly patients is limited, and prompt empirical treatment with vitamin B12 is generally preferable to invasive diagnostic testing

No independent comparative study exists to establish this as a clinically validated conclusion