Dataset Information

Self-Report versus Clinician Examination in Early Parkinson's Disease.

ABSTRACT:

Background

Evaluating the discrepancies between patient-reported measures and clinician examination has implications for formulating individual treatment regimens.

Objective

This study investigated the association between health outcomes and level of self-reported motor-related function impairment relative to clinician-examined motor signs.

Methods

Recently diagnosed PD patients were evaluated using the Parkinson's Progression Marker Initiative (PPMI, N = 420) and the PASADENA phase II clinical trial (N = 316). We calculated the average normalized difference between each participant's part II and III MDS-UPDRS (Movement Disorder Society Unified Parkinson's Disease Rating Scale) scores. Individuals with score differences <25th or >75th percentiles were labeled as low- and high-self-reporters, respectively (those between ranges were labeled intermediate-self-reporters). We compared a wide range of clinical/biomarker readouts among these three groups, using Kruskal-Wallis nonparametric and Pearson's χ² tests. Spearman's correlations were tested for associations between MDS-UPDRS subscales.

Results

In both cohorts, high-self-reporters reported the largest impairment/symptom experience for most motor and nonmotor patient-reported variables. By contrast, these high-self-reporters were similar to or less impaired on clinician-examined and biomarker measures. Patient-reported nonmotor symptoms on MDS-UPDRS part IB showed the strongest positive correlation with self-reported motor-related impairment (PPMI r_s = 0.54, PASADENA r_s = 0.52). This correlation was numerically stronger than the part II and clinician-examined MDS-UPDRS part III correlation (PPMI r_s = 0.38, PASADENA r_s = 0.28).

Conclusion

Self-reported motor-related impairments reflect not only motor signs/symptoms but also other self-reported nonmotor measures. This may indicate (1) a direct impact of nonmotor symptoms on motor-related functioning and/or (2) the existence of general response tendencies in how patients self-rate symptoms. Our findings suggest further investigation into the suitability of MDS-UPDRS II to assess motor-related impairments. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

SUBMITTER: Zolfaghari S

PROVIDER: S-EPMC9299700 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Self-Report versus Clinician Examination in Early Parkinson's Disease.

Zolfaghari Sheida S Thomann Alessandra E AE Lewandowski Natalia N Trundell Dylan D Lipsmeier Florian F Pagano Gennaro G Taylor Kirsten I KI Postuma Ronald B RB

Movement disorders : official journal of the Movement Disorder Society 20211213 3

<h4>Background</h4>Evaluating the discrepancies between patient-reported measures and clinician examination has implications for formulating individual treatment regimens.<h4>Objective</h4>This study investigated the association between health outcomes and level of self-reported motor-related function impairment relative to clinician-examined motor signs.<h4>Methods</h4>Recently diagnosed PD patients were evaluated using the Parkinson's Progression Marker Initiative (PPMI, N = 420) and the PASAD ...[more]

PMID: 34897818

Similar Datasets

Project description:ImportanceHalf of the people who die by suicide make a health care visit within 1 month of their death. However, clinicians lack the tools to identify these patients.ObjectiveTo predict suicide attempts within 1 and 6 months of presentation at an emergency department (ED) for psychiatric problems.Design, setting, and participantsThis prognostic study assessed the 1-month and 6-month risk of suicide attempts among 1818 patients presenting to an ED between February 4, 2015, and March 13, 2017, with psychiatric problems. Data analysis was performed from May 1, 2020, to November 19, 2021.Main outcomes and measuresSuicide attempts 1 and 6 months after presentation to the ED were defined by combining data from electronic health records (EHRs) with patient 1-month (n = 1102) and 6-month (n = 1220) follow-up surveys. Ensemble machine learning was used to develop predictive models and a risk score for suicide.ResultsA total of 1818 patients participated in this study (1016 men [55.9%]; median age, 33 years [IQR, 24-46 years]; 266 Hispanic patients [14.6%]; 1221 non-Hispanic White patients [67.2%], 142 non-Hispanic Black patients [7.8%], 64 non-Hispanic Asian patients [3.5%], and 125 non-Hispanic patients of other race and ethnicity [6.9%]). A total of 137 of 1102 patients (12.9%; weighted prevalence) attempted suicide within 1 month, and a total of 268 of 1220 patients (22.0%; weighted prevalence) attempted suicide within 6 months. Clinicians' assessment alone was little better than chance at predicting suicide attempts, with externally validated area under the receiver operating characteristic curve (AUC) of 0.67 for the 1-month model and 0.60 for the 6-month model. Prediction accuracy was slightly higher for models based on EHR data (1-month model: AUC, 0.71; 6 month model: AUC, 0.65) and was best using patient self-reports (1-month model: AUC, 0.76; 6-month model: AUC, 0.77), especially when patient self-reports were combined with EHR and/or clinician data (1-month model: AUC, 0.77; and 6 month model: AUC, 0.79). A model that used only 20 patient self-report questions and an EHR-based risk score performed similarly well (1-month model: AUC, 0.77; 6 month model: AUC, 0.78). In the best 1-month model, 30.7% (positive predicted value) of the patients classified as having highest risk (top 25% of the sample) made a suicide attempt within 1 month of their ED visit, accounting for 64.8% (sensitivity) of all 1-month attempts. In the best 6-month model, 46.0% (positive predicted value) of the patients classified at highest risk made a suicide attempt within 6 months of their ED visit, accounting for 50.2% (sensitivity) of all 6-month attempts.Conclusions and relevanceThis prognostic study suggests that the ability to identify patients at high risk of suicide attempt after an ED visit for psychiatric problems improved using a combination of patient self-reports and EHR data.

Dataset Information

Self-Report versus Clinician Examination in Early Parkinson's Disease.

Background

Objective

Methods

Results

Conclusion

Publications

Self-Report versus Clinician Examination in Early Parkinson's Disease.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets