Department of Neurology, University of Florida, Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, Gainesville, FL 32610, USA.
Neuromodulation. 2012 May-Jun;15(3):246-50; discussion 250. doi: 10.1111/j.1525-1403.2012.00437.x. Epub 2012 Feb 29.
The objective of this study is to compare a computerized deep brain stimulation (DBS) screening module (Comparing Private Practice vs. Academic Centers in Selection of DBS Candidates [COMPRESS], NeuroTrax Corp., Bellaire, TX, USA) with traditional triage by a movement disorders specialized neurologist as the gold standard.
The COMPRESS consists of a combination of the Florida Surgical Questionnaire for Parkinson disease (FLASQ-PD), a cognitive assessment battery provided by MindStreams® (NeuroTrax Corp.), and the Geriatric Depression Scale and the Zung Anxiety Self-Assessment Scale. COMPRESS resulted in the classification of patients into three categories: "optimal candidate,""probable candidate," and "not a good candidate." Similar categorical ratings made by a referring private practice neurologist and by a trained movement disorders specialist were compared with the ratings generated by COMPRESS.
A total of 19 subjects with Parkinson's disease were enrolled from five private neurological practices. The clinical impressions of the private practice neurologist vs. those of the movement disorders specialist were in agreement approximately half the time (10/19 cases). The movement disorders specialist and COMPRESS agreed on 15/19 cases. A further comparison between outcomes from the entire COMPRESS module and the FLASQ-PD questionnaire by itself resulted in high agreement (18/19 cases in agreement).
The COMPRESS agreed with an in-person evaluation by a movement disorders neurologist approximately 80% of the time. The computerized COMPRESS did not provide any screening advantage over the short FLASQ-PD paper questionnaire. Larger studies will be needed to assess the utility and cost effectiveness of this computerized triage method for DBS.
本研究的目的是将计算机化的深部脑刺激（DBS）筛选模块（比较私人诊所与学术中心在 DBS 候选者选择中的比较[COMPRESS]，NeuroTrax 公司，得克萨斯州 Bellaire）与运动障碍专家的传统分诊方法进行比较，后者作为金标准。
COMPRESS 由佛罗里达州帕金森病外科问卷（FLASQ-PD）、MindStreams®（NeuroTrax 公司）提供的认知评估电池以及老年抑郁量表和 Zung 焦虑自评量表组成。COMPRESS 将患者分为三类：“最佳候选者”、“可能候选者”和“不是好候选者”。由转诊私人诊所神经病学家和经过培训的运动障碍专家做出的类似分类评分与 COMPRESS 生成的评分进行了比较。
共从五家私人神经科诊所招募了 19 名帕金森病患者。私人诊所神经病学家的临床印象与运动障碍专家的印象约有一半时间相符（10/19 例）。运动障碍专家和 COMPRESS 在 15/19 例中达成一致。对整个 COMPRESS 模块和单独的 FLASQ-PD 问卷的结果进行进一步比较，结果高度一致（18/19 例一致）。
COMPRESS 与运动障碍神经病学家的面对面评估约有 80%的时间相符。计算机化的 COMPRESS 并没有比简短的 FLASQ-PD 纸质问卷提供任何筛选优势。需要更大的研究来评估这种计算机化 DBS 分诊方法的实用性和成本效益。
