Validation of the OPTIMIPARK Questionnaire: A Tool to Optimize Treatment in Parkinson's Disease.

Autor: Máñez-Miró JU; Department of Neurology IMED Hospitales Valencia Spain., Vivancos-Matellano F; Department of Neurology, Movement Disorders Unit, Hospital Universitario La Paz Universidad Autónoma de Madrid Madrid Spain., Alonso-Frech F; Department of Neurology, Movement Disorders Unit, Hospital Clínico San Carlos, San Carlos Research Health Institute (IdISSC) Universidad Complutense Madrid Spain., Vela-Desojo L; Department of Neurology Hospital Universitario Fundación Alcorcón Madrid Spain., López-Ariztegui N; Department of Neurology, Movement Disorders Unit Hospital Universitario de Toledo Toledo Spain., López-Manzanares L; Department of Neurology, Movement Disorders Unit Hospital Universitario La Princesa Madrid Spain., Balaguer E; Department of Neurology Hospital General de Catalunya, Sant Cugat del Vallés Research Director, Hospital Universitari General de Catalunya, Hospital Universitari Sagrat Cor, Hospital Quirónsalud del Vallès Barcelona Spain., Martínez-Castrillo JC; Movement Disorders and Neurodegenerative Diseases Unit, IRYCIS Hospital Ramón y Cajal Madrid Spain., Herrero-Infante Y; Department of Neurology, Movement Disorders Unit, Hospital Universitario La Paz Universidad Autónoma de Madrid Madrid Spain., Gasca-Salas C; HM CINAC Madrid (Centro Integral de Neurociencias Abarca Campal) Hospital Universitario HM Puerta del Sur, HM Hospitales Madrid Spain., Morales-Casado MI; Department of Neurology, Movement Disorders Unit Hospital Universitario de Toledo Toledo Spain., Casas E; Department of Neurology, Movement Disorders Unit Hospital Universitario La Princesa Madrid Spain., Hernández A; Department of Neurology Hospital General de Catalunya, Sant Cugat del Vallés Research Director, Hospital Universitari General de Catalunya, Hospital Universitari Sagrat Cor, Hospital Quirónsalud del Vallès Barcelona Spain., Pareés I; Movement Disorders and Neurodegenerative Diseases Unit, IRYCIS Hospital Ramón y Cajal Madrid Spain., Tegel-Ayuela I; Medical Affairs Laboratorios Bial, S.A. Madrid Spain., Martínez-Fernández R; HM CINAC Madrid (Centro Integral de Neurociencias Abarca Campal) Hospital Universitario HM Puerta del Sur, HM Hospitales Madrid Spain., Martinez-Martin P; Centre for Networked Biomedical Research in Neurodegenerative Diseases Carlos III Institute of Health Madrid Spain.
Jazyk: angličtina
Zdroj: Movement disorders clinical practice [Mov Disord Clin Pract] 2022 Oct 18; Vol. 9 (8), pp. 1085-1093. Date of Electronic Publication: 2022 Oct 18 (Print Publication: 2022).
DOI: 10.1002/mdc3.13581
Abstrakt: Background: Dopamine replacement therapy reduces most motor and nonmotor features of Parkinson's disease. However, with disease progression, adjustments of dopaminergics and the application of advanced therapies must be considered.
Objectives: To validate the OPTIMIPARK questionnaire as a tool to help clinicians make therapeutic decisions on patients treated with levodopa.
Methods: We tested a questionnaire including 9 items encompassing motor and nonmotor signs, complications, and disability in a multicenter, observational, cross-sectional study. A neurologist (neurologist 1 [N1]) assessed patients according to regular clinical practice and blinded to the OPTIMIPARK questionnaire score. Therapeutic decisions were classified as "no changes," "adjustment of conventional treatment," and "advanced therapy indicated." External neurologists (neurologist 3 [N3] and neurologist 4 [N4]), who only knew the patient age, years of disease, and current treatment, made their therapeutic decisions based on the OPTIMIPARK score. Concordance between the criterion of the N1 versus the OPTIMIPARK-based N3-N4 consensus was analyzed applying weighted κ. The area under Receiving Operating Characteristic (ROC) curves was calculated for OPTIMIPARK scores.
Results: A total of 113 patients with Parkinson's disease were included. The OPTIMIPARK-based decision led to a higher proportion of patients requiring therapeutic modification than N1 assessment (74% vs. 60%; P  = 0.002). Concordance between the N1 and N3-N4 decisions was moderate, whereas interobserver agreement among N3 and N4 was high. Area Under the Curve(AUC) values of 0.83 and 0.82 were found for "no changes" and "advanced therapy indicated" decisions by the N1 neurologist.
Conclusions: OPTIMIPARK might be more sensitive than regular clinical practice in suggesting the need for a therapeutic change. Furthermore, the low and high scores identify with high accuracy well-adjusted patients and candidates for advanced therapy, respectively.
(© 2022 International Parkinson and Movement Disorder Society.)
Databáze: MEDLINE
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