Neurocenter of Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland.
Clinical Neurophysiology Unit, Department of Neurology, Pierre Zobda-Quitman Hospital, University Hospitals of Martinique, Fort-de-France, Martinique, France.
J Parkinsons Dis. 2019;9(4):803-809. doi: 10.3233/JPD-191662.
Subjective symptoms, which are retrospectively assessed during clinical interviews in the office, may be influenced by patient recall in Parkinson's disease (PD). Prospective collection of subjective data might be an effective tool to overcome this bias.
We investigated the correspondence between prospectively and retrospectively assessed motor symptoms in PD.
Forty-two consecutive patients (9 females, 67±9.8 years old) with mild to moderate PD reported their symptoms four times a day for two weeks, using the "SleepFit" application (app) for tablets. This app incorporates a new Visual Analogue Scale assessing global mobility (m-VAS), and the Scales for Outcome in Parkinson Assessment Diary Card (SCOPA-DC). At day 14, the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) parts II and IV questionnaires were completed at the hospital. Agreement (root mean square difference) and the tendency to under- or overestimate their symptoms by patients (relative difference after normalization) were calculated to compare prospectively vs. retrospectively collected information.
Although agreement was good for overall scores (m-VAS: 10.0%; SCOPA-DC: 18.3%), and for single motor symptoms (involuntary movements, hand dexterity, walking, changing position; each <20%), some individuals with more advanced disease, higher fatigue or worse sleep quality showed poor symptom recall in retrospect. Moreover, a subgroup of patients (16.7%) either over- or underestimated symptom severity.
Regular, prospective monitoring of motor symptoms is suitable in PD patients. SleepFit might be a useful tool in routine practice to identify patients tending to under- or overestimate their symptoms, and for their follow-up.
在办公室的临床访谈中回顾性评估的主观症状可能会受到帕金森病（PD）患者回忆的影响。前瞻性收集主观数据可能是克服这一偏差的有效工具。
我们研究了 PD 中前瞻性和回顾性评估的运动症状之间的一致性。
42 名连续的 PD 患者（9 名女性，67±9.8 岁）使用平板电脑上的“SleepFit”应用程序（app）每天四次报告他们的症状两周。该应用程序包含一个新的评估整体活动能力的视觉模拟量表（m-VAS）和帕金森评估日记卡片量表（SCOPA-DC）。在第 14 天，在医院完成运动障碍协会统一帕金森病评定量表（MDS-UPDRS）第二部分和第四部分问卷。为了比较前瞻性和回顾性收集的信息，计算了（均方根差）和患者对其症状的低估或高估的趋势（归一化后的相对差异）。
尽管整体评分（m-VAS：10.0%；SCOPA-DC：18.3%）和单项运动症状（不自主运动、手灵巧性、行走、改变体位；每项<20%）的一致性较好，但一些疾病更严重、疲劳程度更高或睡眠质量更差的患者在回顾性评估中对症状的回忆较差。此外，一小部分患者（16.7%）过度或低估了症状严重程度。
定期、前瞻性监测运动症状适用于 PD 患者。SleepFit 可能是常规实践中识别倾向于过度或低估症状的患者以及对其进行随访的有用工具。
