帕金森病中UPSIT西班牙语版的诊断准确性、项目分析及年龄效应

Diagnostic Accuracy, Item Analysis and Age Effects of the UPSIT Spanish Version in Parkinson's Disease.

作者信息

Campabadal A, Segura B, Baggio H C, Abos A, Uribe C, Garcia-Diaz A I, Marti M J, Valldeoriola F, Compta Y, Bargallo N, Junque C

机构信息

Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.

Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain.

出版信息

Arch Clin Neuropsychol. 2019 Jun 1;34(4):435-444. doi: 10.1093/arclin/acy053.

DOI:10.1093/arclin/acy053

PMID:30007334

Abstract

OBJECTIVE

The University of Pennsylvania Smell Identification Test (UPSIT) is the most commonly used test to detect olfactory impairment in Parkinson's disease (PD), but the cut-off score for clinical purposes is often difficult to establish because of age and sex effects. The current work aims to study the sensitivity and specificity of the UPSIT Spanish version and its accuracy in discriminating PD patients at different age groups from healthy controls (HC), and to perform an item analysis.

METHOD

Ninety-seven non-demented PD patients and 65 HC were assessed with the UPSIT Spanish version. Sensitivity, specificity, and diagnostic accuracy for PD were calculated. Multiple regression analysis was used to define predictors of UPSIT scores.

RESULTS

Using the normative cut-off score for anosmia (≤18), the UPSIT showed a sensitivity of 54.6% with a specificity of 100.0% for PD. We found that, using the UPSIT cut-off score of ≤25, sensitivity was 81.4% and specificity 84.6% (area under the receiver operating characteristic curve = 0.908). Diagnosis and age were good predictors of UPSIT scores (B = -10.948; p < .001; B = -0.203; p < .001). When optimal cut-off scores were considered according to age ranges (≤60, 61-70, and ≥71), sensitivity and specificity values were >80.0% for all age groups.

CONCLUSIONS

In the Spanish UPSIT version, sensitivity and specificity are improved when specific cut-off scores for different age groups are computed.

摘要

目的

宾夕法尼亚大学嗅觉识别测试（UPSIT）是检测帕金森病（PD）嗅觉障碍最常用的测试，但由于年龄和性别影响，临床使用的临界值往往难以确定。当前研究旨在探讨UPSIT西班牙语版的敏感性和特异性，以及其区分不同年龄组PD患者与健康对照（HC）的准确性，并进行项目分析。

方法

使用UPSIT西班牙语版对97例非痴呆PD患者和65例HC进行评估。计算PD的敏感性、特异性和诊断准确性。采用多元回归分析确定UPSIT评分的预测因素。

结果

采用嗅觉减退的标准临界值（≤18），UPSIT对PD的敏感性为54.6%，特异性为100.0%。我们发现，使用UPSIT临界值≤25时，敏感性为81.4%，特异性为84.6%（受试者工作特征曲线下面积=0.908）。诊断和年龄是UPSIT评分的良好预测因素（B=-10.948；p<.001；B=-0.203；p<.001）。根据年龄范围（≤60岁、61-70岁和≥71岁）考虑最佳临界值时，所有年龄组的敏感性和特异性值均>80.0%。