Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany.
DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany.
Mov Disord. 2016 Sep;31(9):1263-71. doi: 10.1002/mds.26673. Epub 2016 Jun 7.
Recently, quantitative, objective, and easy-to-use technology-based tools that can assess PD features over long time periods have been developed and generate clinically relevant and comparable patient information. Herein, we present a clinician's view on technological developments that have the potential to revolutionize clinical management concepts in PD. According to prominent examples in clinical medicine (e.g., blood glycosylated hemoglobin and blood pressure), we argue that the consideration of technology-based assessment in the clinical management of PD must be based on specific assumptions: (1) It provides a valid and accurate parameter of a clinically relevant feature of the disease; (2) there is confirmed evidence that the parameter has an ecologically relevant effect on the specific clinical application; (3) a target range can be defined wherein the parameter reflects the adequate treatment response; and (4) implementation is simple to allow repetitive use. Currently, there are no technology-based tools available that fulfil all these assumptions; however, assessments of akinesia, dyskinesia, motor fluctuations, physical inactivity, gait impairment, and postural instability seem relatively close to the specifications described. An iterative process of integration is recommended to bring technology-based tools into clinical practice. © 2016 International Parkinson and Movement Disorder Society.
近年来，已经开发出了定量、客观且易于使用的基于技术的工具，这些工具可以在长时间内评估 PD 的特征，并生成具有临床相关性和可比性的患者信息。在此，我们从临床医生的角度介绍了一些有可能彻底改变 PD 临床管理理念的技术发展。根据临床医学中的突出例子（例如，血糖糖化血红蛋白和血压），我们认为，基于技术的评估在 PD 的临床管理中必须基于以下具体假设：（1）它提供了疾病具有临床相关性特征的有效且准确的参数；（2）已经有明确的证据表明该参数对特定的临床应用具有生态相关性的影响；（3）可以定义一个目标范围，其中参数反映了充分的治疗反应；（4）实施起来简单，可以进行重复使用。目前，尚无满足所有这些假设的基于技术的工具；但是，对运动不能、运动障碍、运动波动、身体不活动、步态障碍和姿势不稳的评估似乎相对接近所描述的规范。建议采用迭代整合的方法将基于技术的工具引入临床实践。国际帕金森病和运动障碍学会 2016 年版权所有。
