Psychometric Properties of Clinical Indicators for Identification and Management of Advanced Parkinson's Disease: Real-World Evidence From G7 Countries.

Autor: Antonini A; Parkinson and Movement Disorders Unit, Study Centre for Neurodegeneration, Department of Neuroscience, University of Padova, Padova, Italy., Pahwa R; Medical Center, University of Kansas, Kansas, KS, USA., Odin P; University of Lund, Lund, Sweden., Henriksen T; Movement Disorder Clinic, University Hospital of Bispebjerg, Copenhagen, Denmark., Soileau MJ; Texas Movement Disorder Specialists, Georgetown, TX, USA., Rodriguez-Cruz R; Synaptic Precision, Inc, Orlando, FL, USA., Isaacson SH; Parkinson's Disease and Movement Disorders Center, Boca Raton, FL, USA., Merola A; Madden Center for Parkinson Disease and Other Movement Disorders, Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA., Lindvall S; European Parkinson's Disease Association, Sevenoaks, UK., Domingos J; European Parkinson's Disease Association, Sevenoaks, UK.; Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do CiiEM, Almada, Portugal., Alobaidi A; AbbVie Inc., North Chicago, IL, USA.; University of Illinois at Chicago, Chicago, IL, USA., Jalundhwala YJ; AbbVie Inc., North Chicago, IL, USA., Kandukuri PL; AbbVie Inc., North Chicago, IL, USA., Parra JC; AbbVie Inc., North Chicago, IL, USA., Kukreja PK; AbbVie Inc., North Chicago, IL, USA., Onuk K; AbbVie Inc., North Chicago, IL, USA., Bergmann L; AbbVie Inc., North Chicago, IL, USA., Pike J; Adelphi Real World, Adelphi Mill, Bollington, UK., Ray Chaudhuri K; King's College and Parkinson Foundation Centre of Excellence, Kings College Hospital London, London, UK. ray.chaudhuri@kcl.ac.uk.
Jazyk: angličtina
Zdroj: Neurology and therapy [Neurol Ther] 2022 Mar; Vol. 11 (1), pp. 303-318. Date of Electronic Publication: 2022 Jan 11.
DOI: 10.1007/s40120-021-00313-9
Abstrakt: Introduction: Standardized and validated criteria to define advanced Parkinson's disease (PD) or identify patient eligibility for device-aided therapy are needed. This study assessed the psychometric properties of clinical indicators of advanced PD and eligibility for device-aided therapy in a large population.
Methods: This retrospective analysis of the Adelphi Parkinson's Disease Specific Programme collected data from device-aided therapy-naïve people with PD in G7 countries. We assessed the presence of 15 clinical indicators of advancing PD and seven indicators of eligibility for device-aided therapy in patients classified with advanced PD or as eligible for device-aided therapy by the treating physician. Accuracy was assessed using area under the curve (AUC) and multivariable logistic regression models. Construct validity was examined via known-group comparisons of disease severity and burden among patients with and without each clinical indicator.
Results: Of 4714 PD patients, 14.9% were classified with advanced PD and 17.5% as eligible for device-aided therapy by physician judgment. The presence of each clinical indicator was 1.9- to 7.3-fold more likely in patients classified with advanced PD. Similarly, the presence of device-aided therapy eligibility indicators was 1.8- to 5.5-fold more likely in patients considered eligible for device-aided therapy. All indicators demonstrated high clinical screening accuracy for identifying advanced PD (AUC range 0.84-0.89) and patients eligible for device-aided therapy (AUC range 0.73-0.80). The Unified Parkinson's Disease Rating Scale (UPDRS) score, cognitive function, quality of life, and caregiver burden were significantly worse in indicator-positive patients.
Conclusion: Specific clinical indicators of advanced PD and eligibility for device-aided therapy demonstrated excellent psychometric properties in a large sample, and thus may provide an objective and reliable approach for patient identification and treatment optimization.
(© 2022. The Author(s).)
Databáze: MEDLINE
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