Psychometric Properties of Clinical Indicators for Identification and Management of Advanced Parkinson’s Disease: Real-World Evidence From G7 Countries

Angelo Antonini, Rajesh Pahwa, Per Odin, Tove Henriksen, Michael J. Soileau, Ramon Rodriguez-Cruz, Stuart H. Isaacson, Aristide Merola, Susanna Lindvall, Josefa Domingos, Ali Alobaidi, Yash J. Jalundhwala, Prasanna L. Kandukuri, Juan Carlos Parra, Pavnit K. Kukreja, Koray Onuk, Lars Bergmann, James Pike, K. Ray Chaudhuri*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
30 Downloads (Pure)

Abstract

Introduction: Standardized and validated criteria to define advanced Parkinson’s disease (PD) or identify patient eligibility for device-aided therapy are needed. This study assessed the psychometric properties of clinical indicators of advanced PD and eligibility for device-aided therapy in a large population. Methods: This retrospective analysis of the Adelphi Parkinson’s Disease Specific Programme collected data from device-aided therapy-naïve people with PD in G7 countries. We assessed the presence of 15 clinical indicators of advancing PD and seven indicators of eligibility for device-aided therapy in patients classified with advanced PD or as eligible for device-aided therapy by the treating physician. Accuracy was assessed using area under the curve (AUC) and multivariable logistic regression models. Construct validity was examined via known-group comparisons of disease severity and burden among patients with and without each clinical indicator. Results: Of 4714 PD patients, 14.9% were classified with advanced PD and 17.5% as eligible for device-aided therapy by physician judgment. The presence of each clinical indicator was 1.9- to 7.3-fold more likely in patients classified with advanced PD. Similarly, the presence of device-aided therapy eligibility indicators was 1.8- to 5.5-fold more likely in patients considered eligible for device-aided therapy. All indicators demonstrated high clinical screening accuracy for identifying advanced PD (AUC range 0.84–0.89) and patients eligible for device-aided therapy (AUC range 0.73–0.80). The Unified Parkinson’s Disease Rating Scale (UPDRS) score, cognitive function, quality of life, and caregiver burden were significantly worse in indicator-positive patients. Conclusion: Specific clinical indicators of advanced PD and eligibility for device-aided therapy demonstrated excellent psychometric properties in a large sample, and thus may provide an objective and reliable approach for patient identification and treatment optimization.

Original languageEnglish
Pages (from-to)303-318
Number of pages16
JournalNeurology and Therapy
Volume11
Issue number1
Early online date11 Jan 2022
DOIs
Publication statusPublished - 31 Mar 2022

Keywords

  • Accuracy
  • Advanced Parkinson’s disease
  • Clinical indicators
  • Device-aided therapy eligibility
  • Validity

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