van de Vijver D A, Stricker B H, Breteler M M, Roos R A, Porsius A J, de Boer A
Utrecht University, Department of Pharmaco-epidemiology and Pharmacotherapy, P.O. Box 80082, 3508 TB Utrecht, The Netherlands.
Pharm World Sci. 2001 Aug;23(4):148-52. doi: 10.1023/a:1011807919632.
The aim of this study was to determine whether use of antiparkinsonian drugs in pharmacy records can be used as a marker for patients with Parkinson's disease (PD).
Data were obtained from the Rotterdam Study, a community-based prospective cohort study among people aged 55 years or older who were all screened for PD. For 5510 persons, of whom 74 had PD, pharmacy records were available. Stepwise logistic regression analysis was used to evaluate whether age, sex and use of the antiparkinsonian drugs amantadine, anticholinergics, dopamine agonists, levodopa and selegiline, were predictive variables for PD. For each individual a probability for having PD was calculated. Sensitivity, specificity and positive predictive value (PPV) were calculated at different cut-off values based on calculated probabilities.
More than 90% of the users of levodopa, bromocriptine, selegiline, and users of at least two different antiparkinsonian drugs had PD. Age, use of amantadine, anticholinergics, bromocriptine, levodopa, and selegiline were predictive variables for PD. After application of different cut-off values, sensitivity was at most 66.2%, and specificity was at least 99.8%. A PPV of higher than 90% was obtained at higher probabilities.
Based on the high PPV of our predictive model, antiparkinsonian drugs can be used as a reliable marker for PD in pharmacy records. Because sensitivity is low, pharmacy records cannot be used to estimate prevalence of PD.
本研究旨在确定药房记录中抗帕金森病药物的使用是否可作为帕金森病（PD）患者的一个标志物。
数据取自鹿特丹研究，这是一项针对55岁及以上人群的基于社区的前瞻性队列研究，所有参与者均接受了PD筛查。在5510名参与者中，74人患有PD，且有药房记录。采用逐步逻辑回归分析来评估年龄、性别以及抗帕金森病药物金刚烷胺、抗胆碱能药物、多巴胺激动剂、左旋多巴和司来吉兰的使用是否为PD的预测变量。为每个个体计算患PD的概率。根据计算出的概率，在不同的临界值下计算敏感性、特异性和阳性预测值（PPV）。
超过90%的左旋多巴、溴隐亭、司来吉兰使用者以及至少使用两种不同抗帕金森病药物的使用者患有PD。年龄、金刚烷胺、抗胆碱能药物、溴隐亭、左旋多巴和司来吉兰的使用是PD的预测变量。应用不同的临界值后，敏感性最高为66.2%，特异性至少为99.8%。在较高概率下获得了高于90%的PPV。
基于我们预测模型的高PPV，抗帕金森病药物可作为药房记录中PD的可靠标志物。由于敏感性较低，药房记录不能用于估计PD的患病率。
