Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
Neuroepidemiology. 2014;43(3-4):178-93. doi: 10.1159/000368167. Epub 2014 Nov 13.
Several instruments have been developed to screen Parkinson's disease (PD); yet, there is no consensus on the items, number of questions, and diagnostic accuracy. We aimed to develop a new questionnaire combining the best items with highest validity to screen parkinsonism and to compare its diagnostic value with that of the previous instruments using the same database.
157 patients with parkinsonism and 110 healthy controls completed a comprehensive screening questionnaire consisting of 25 items on different PD symptoms used in previous studies. To select the optimal items, clinical utility index (CUI) was calculated and those who met at least good negative utility (CUI ≥0.64) were selected. Receiver operating characteristics (ROC) curves analysis was used to compare the area under the curve (AUC) of different screening instruments.
Six items on 'stiffness & rigidity', 'tremor & shaking', 'troublesome buttoning', 'troublesome arm swing', 'feet stuck to floor' and 'slower daily activity' demonstrated good CUI. The new screening instrument had the largest AUC (0.977) compared to other instruments.
We selected a new set of six items to screen parkinsonism, which showed higher diagnostic values compared to the previously developed questionnaires. This screening instrument could be used in population-based PD surveys in poor-resource settings.
已经开发出几种用于筛查帕金森病（PD）的工具；然而，在项目、问题数量和诊断准确性方面尚未达成共识。我们旨在开发一种新的问卷，结合最佳项目和最高有效性来筛查帕金森症，并使用相同的数据库比较其与先前工具的诊断价值。
157 名帕金森症患者和 110 名健康对照者完成了一个由 25 个项目组成的综合筛查问卷，这些项目涉及先前研究中使用的不同 PD 症状。为了选择最佳项目，计算了临床效用指数（CUI），并选择了至少具有良好负效用（CUI≥0.64）的项目。使用接收者操作特征（ROC）曲线分析比较了不同筛查工具的曲线下面积（AUC）。
六个关于“僵硬和僵直”、“震颤和颤抖”、“扣扣子困难”、“手臂摆动困难”、“脚粘在地板上”和“日常活动较慢”的项目具有良好的 CUI。与其他工具相比，新的筛查工具的 AUC（0.977）最大。
我们选择了一组新的六个项目来筛查帕金森症，与先前开发的问卷相比，其诊断价值更高。这种筛查工具可用于资源匮乏环境中的人群 PD 调查。
