Development and external validation of a prognostic model in newly diagnosed Parkinson disease
| Autor: | Bart Post, Sarah L Mason, Ben Schmand, Thomas Foltynie, Roger A. Barker, Caroline H. Williams-Gray, Daan C. Velseboer, Jonathan R. Evans, Luuk Wieske, Rob J. de Haan, Rob M.A. de Bie |
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| Přispěvatelé: | Faculty of Science, Brein en Cognitie (Psychologie, FMG), ANS - Neurodegeneration, Graduate School, Neurology, Medical Psychology, AMS - Amsterdam Movement Sciences, APH - Amsterdam Public Health, Clinical Research Unit |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Models Neurological Article Cohort Studies 03 medical and health sciences 0302 clinical medicine Rating scale Internal medicine Humans Medicine Dementia Longitudinal Studies Prospective Studies 030212 general & internal medicine Prospective cohort study Aged Netherlands Aged 80 and over Receiver operating characteristic business.industry Parkinson Disease Middle Aged Prognosis medicine.disease Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] Comorbidity United Kingdom Confidence interval Cohort Physical therapy Female Neurology (clinical) business 030217 neurology & neurosurgery Follow-Up Studies Cohort study |
| Zdroj: | Neurology, 86(11), 986-993. Lippincott Williams & Wilkins Neurology, 86, 11, pp. 986-93 Neurology, 86(11), 986-993. Lippincott Williams and Wilkins Neurology, 86, 986-93 |
| ISSN: | 0028-3878 |
| Popis: | Item does not contain fulltext OBJECTIVE: To develop a prognostic model to predict disease outcomes in individual patients with Parkinson disease (PD) and perform an external validation study in an independent cohort. METHODS: Model development was done in the Comorbidity and Aging in Rehabilitation Patients: The Influence on Activities (CARPA) cohort (Netherlands). External validation was performed using the Cambridgeshire Parkinson's Incidence from GP to Neurologist (CamPaIGN) cohort (UK). Both are longitudinal incident cohort studies that prospectively followed up patients with PD from the time of diagnosis. A composite outcome measure was made in which patients were classified as having an unfavorable prognosis when they had postural instability or dementia at the 5-year assessment (or at the last assessment before loss to follow-up), or had died before this time. The final model was derived with a backward selection strategy from candidate predictor variables that were measured at baseline. RESULTS: In the resulting model, higher patient age, higher Unified Parkinson's Disease Rating Scale motor examination axial score, and a lower animal fluency score were all associated with a higher probability of an unfavorable outcome. External validation confirmed good discriminative ability between favorable and unfavorable outcomes with an area under the receiver operating characteristic curve of 0.85 (95% confidence interval 0.77-0.93) and a well-calibrated model with a calibration slope of 1.13 and no significant lack of fit (Hosmer-Lemeshow test: p = 0.39). CONCLUSION: We constructed a model that allows individual patient prognostication at 5 years from diagnosis, using a small set of predictor variables that can easily be obtained by clinicians or research nurses. |
| Databáze: | OpenAIRE |
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