Woodrow Holly, Horne Malcolm K, Fernando Chathurini V, Kotschet Katya E
Florey Institute of Neuroscience and Mental Health Parkville, Melbourne, VIC, 3010, Australia.
University of Melbourne Parkville, Melbourne, VIC, 3010, Australia.
NPJ Parkinsons Dis. 2020 Nov 20;6(1):35. doi: 10.1038/s41531-020-00136-9.
Medical conditions with effective therapies are usually managed with objective measurement and therapeutic targets. Parkinson's disease has effective therapies, but continuous objective measurement has only recently become available. This blinded, controlled study examined whether management of Parkinson's disease was improved when clinical assessment and therapeutic decisions were aided by objective measurement. The primary endpoint was improvement in the Movement Disorder Society-United Parkinson's Disease Rating Scale's (MDS-UPDRS) Total Score. In one arm, objective measurement assisted doctors to alter therapy over successive visits until objective measurement scores were in target. Patients in the other arm were conventionally assessed and therapies were changed until judged optimal. There were 75 subjects in the objective measurement arm and 79 in the arm with conventional assessment and treatment. There were statistically significant improvements in the moderate clinically meaningful range in the MDS-UPDRS Total, III, IV scales in the arm using objective measurement, but not in the conventionally treated arm. These findings show that global motor and non-motor disability is improved when management of Parkinson's disease is assisted by objective measurement.
有有效治疗方法的医学病症通常通过客观测量和治疗目标来管理。帕金森病有有效的治疗方法,但持续的客观测量直到最近才可用。这项双盲对照研究考察了在客观测量辅助临床评估和治疗决策时,帕金森病的管理是否得到改善。主要终点是运动障碍协会统一帕金森病评定量表(MDS-UPDRS)总分的改善。在一组中,客观测量辅助医生在连续就诊时调整治疗,直到客观测量分数达到目标。另一组患者接受常规评估,治疗方案改变直到被判定为最佳。客观测量组有75名受试者,常规评估和治疗组有79名。在使用客观测量的组中,MDS-UPDRS总分、III量表和IV量表在中度具有临床意义的范围内有统计学显著改善,而在常规治疗组中则没有。这些发现表明,当帕金森病的管理有客观测量辅助时,整体运动和非运动残疾状况会得到改善。