Nicoletti Alessandra, Salemi Giuseppe, Morgante Letterio, Le Pira Francesco, Epifanio Antonio, Reggio Arturo, Basile Giorgio, Savettieri Giovanni
Department of Neuroscinces, University of Catania, Via S. Sofia No. 78, Catania 95125, Italy.
Arch Gerontol Geriatr. 2004 Jan-Feb;38(1):37-44. doi: 10.1016/s0167-4943(03)00081-5.
We evaluated the sensitivity and specificity of a screening instrument developed for use in a two-phase neuroepidemiological survey in Sicily. The Sicilian Epidemiological Dementia Study (SEDES) project will evaluate the prevalence and incidence of dementia, parkinsonisms and essential tremor in four Sicilian municipalities. It is a two-phase door-to-door survey. To identify subjects with possible neurological disorders, in this study, we developed a screening instrument including a symptoms questionnaire and simple physical tasks for parkinsonisms and essential tremor. The Mini-Mental State Examination (MMSE) was chosen for screening dementia. The symptoms questionnaire and simple tasks developed to identify possible patients with parkinsonism and essential tremor, was tested in a hospital setting. To evaluate sensitivity, we selected 20 patients with essential tremor and 40 with Parkinson's disease (20 with Stages I-II and 20 with Stages III-V) [Neurology 17 (1967) 427]. To evaluate specificity we also selected 20 healthy subjects. The screening instrument was administered in a hospital setting by trained interviewers. Sensitivity of the screening instrument (questionnaire plus simple tasks) was 100% for essential tremor and parkinsonisms regardless of the stage. Specificity of the instrument was 90% (95% CI 66.9-98.2); the predictive positive value was 90.9%, while the negative predictive value was 100%. Even if validity was assessed in a hospital setting, the high sensitivity and specificity obtained suggest that the instrument could be an appropriate screening tool for parkinsonisms and essential tremor in a two-phase neuroepidemiological survey.
我们评估了一种为西西里岛两阶段神经流行病学调查开发的筛查工具的敏感性和特异性。西西里岛流行病学痴呆研究（SEDES）项目将评估四个西西里岛城市中痴呆、帕金森综合征和特发性震颤的患病率和发病率。这是一项两阶段的挨家挨户调查。为了识别可能患有神经系统疾病的受试者，在本研究中，我们开发了一种筛查工具，包括一份症状问卷以及针对帕金森综合征和特发性震颤的简单身体任务。选择简易精神状态检查表（MMSE）来筛查痴呆。为识别可能患有帕金森综合征和特发性震颤的患者而开发的症状问卷和简单任务，在医院环境中进行了测试。为了评估敏感性，我们选择了20名特发性震颤患者和40名帕金森病患者（20名处于I-II期，20名处于III-V期）[《神经病学》17（1967）427]。为了评估特异性，我们还选择了20名健康受试者。筛查工具由经过培训的访谈员在医院环境中进行发放。筛查工具（问卷加简单任务）对特发性震颤和帕金森综合征的敏感性无论疾病阶段如何均为100%。该工具的特异性为90%（95%可信区间66.9 - 98.2）；阳性预测值为90.9%，而阴性预测值为100%。即使在医院环境中评估了有效性，但所获得的高敏感性和特异性表明，该工具可能是两阶段神经流行病学调查中帕金森综合征和特发性震颤的合适筛查工具。
