Referring Parkinson's disease patients for deep brain stimulation: a RAND/UCLA appropriateness study.
Identifieur interne : 000331 ( PubMed/Corpus ); précédent : 000330; suivant : 000332Referring Parkinson's disease patients for deep brain stimulation: a RAND/UCLA appropriateness study.
Auteurs : Elena Moro ; Michael Schüpbach ; Tobias W Chter ; Niels Allert ; Roberto Eleopra ; Christopher R. Honey ; Mauricio Rueda ; Mya C. Schiess ; Yasushi Shimo ; Peter Valkovic ; Alan Whone ; Herman StoevelaarSource :
- Journal of neurology [ 1432-1459 ] ; 2016.
English descriptors
- KwdEn :
- MESH :
- diagnosis : Parkinson Disease.
- standards : Practice Guidelines as Topic, Referral and Consultation.
- therapy : Parkinson Disease.
- Aged, Aged, 80 and over, Deep Brain Stimulation, Female, Humans, Male, Middle Aged, Severity of Illness Index.
Abstract
In 2005, a European expert panel developed and validated an electronic tool to support the appropriate referral of patients with Parkinson's disease (PD) for the consideration of deep brain stimulation (DBS). Since new evidence has become available over the last decade an update of the tool is necessary. A world-wide expert panel (71 neurologists and 11 neurosurgeons) used the RAND/UCLA Appropriateness Method to assess the appropriateness of referral for 1296 scenarios (9-point scale). Scenarios were permutations of 8 clinical variables relevant to the decision of referral. Appropriateness of referral was calculated on the basis of the median score and the extent of agreement. Compared to 2005, the impact of clinical variables on the appropriateness of referral was similar for severity of on-off fluctuations, dyskinesias and refractory tremor (positive association, p < 0.001), and cognitive impairment (negative association, p < 0.001). A relatively stronger negative impact was seen for levodopa-unresponsive gait and balance disturbances as well as older age, the latter most likely due to a higher cut-off value (75 versus 70 years in the previous study). The impact of PD duration on the appropriateness of referral was less pronounced than in 2005. The contribution of the newly included variable 'non-motor side effects of anti-PD medication' was very modest. Based on these results the panel produced new recommendations on the appropriateness of referral for the evaluation of DBS in PD patients. Differences from the previous study reflect the new clinical evidence, particularly related to the use of DBS in an earlier stage of PD. The validation of the updated recommendations is in progress.
DOI: 10.1007/s00415-015-7942-x
PubMed: 26530503
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Honey</name><affiliation><nlm:affiliation>Division of Neurosurgery, University of British Columbia, Vancouver, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Rueda, Mauricio" sort="Rueda, Mauricio" uniqKey="Rueda M" first="Mauricio" last="Rueda">Mauricio Rueda</name><affiliation><nlm:affiliation>Departamento de Neurociencias, Fundación Cardiovascular de Colombia, Bucaramanga, Colombia.</nlm:affiliation></affiliation></author><author><name sortKey="Schiess, Mya C" sort="Schiess, Mya C" uniqKey="Schiess M" first="Mya C" last="Schiess">Mya C. Schiess</name><affiliation><nlm:affiliation>Department of Neurology, University of Texas Medical School at Houston, Texas, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Shimo, Yasushi" sort="Shimo, Yasushi" uniqKey="Shimo Y" first="Yasushi" last="Shimo">Yasushi Shimo</name><affiliation><nlm:affiliation>Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.</nlm:affiliation></affiliation></author><author><name sortKey="Valkovic, Peter" sort="Valkovic, Peter" uniqKey="Valkovic P" first="Peter" last="Valkovic">Peter Valkovic</name><affiliation><nlm:affiliation>2nd Department of Neurology, Comenius University Faculty of Medicine and University Hospital Bratislava, Bratislava, Slovakia.</nlm:affiliation></affiliation></author><author><name sortKey="Whone, Alan" sort="Whone, Alan" uniqKey="Whone A" first="Alan" last="Whone">Alan Whone</name><affiliation><nlm:affiliation>Department of Neurology, Frenchay Hospital, Bristol, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Stoevelaar, Herman" sort="Stoevelaar, Herman" uniqKey="Stoevelaar H" first="Herman" last="Stoevelaar">Herman Stoevelaar</name><affiliation><nlm:affiliation>Centre for Decision Analysis and Support, Ismar Healthcare, Lier, Belgium. herman.stoevelaar@ismar.com.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Journal of neurology</title><idno type="eISSN">1432-1459</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Deep Brain Stimulation</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (therapy)</term><term>Practice Guidelines as Topic (standards)</term><term>Referral and Consultation (standards)</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Practice Guidelines as Topic</term><term>Referral and Consultation</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Deep Brain Stimulation</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Severity of Illness Index</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In 2005, a European expert panel developed and validated an electronic tool to support the appropriate referral of patients with Parkinson's disease (PD) for the consideration of deep brain stimulation (DBS). Since new evidence has become available over the last decade an update of the tool is necessary. A world-wide expert panel (71 neurologists and 11 neurosurgeons) used the RAND/UCLA Appropriateness Method to assess the appropriateness of referral for 1296 scenarios (9-point scale). Scenarios were permutations of 8 clinical variables relevant to the decision of referral. Appropriateness of referral was calculated on the basis of the median score and the extent of agreement. Compared to 2005, the impact of clinical variables on the appropriateness of referral was similar for severity of on-off fluctuations, dyskinesias and refractory tremor (positive association, p < 0.001), and cognitive impairment (negative association, p < 0.001). A relatively stronger negative impact was seen for levodopa-unresponsive gait and balance disturbances as well as older age, the latter most likely due to a higher cut-off value (75 versus 70 years in the previous study). The impact of PD duration on the appropriateness of referral was less pronounced than in 2005. The contribution of the newly included variable 'non-motor side effects of anti-PD medication' was very modest. Based on these results the panel produced new recommendations on the appropriateness of referral for the evaluation of DBS in PD patients. Differences from the previous study reflect the new clinical evidence, particularly related to the use of DBS in an earlier stage of PD. The validation of the updated recommendations is in progress.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26530503</PMID><DateCreated><Year>2016</Year><Month>01</Month><Day>23</Day></DateCreated><DateCompleted><Year>2016</Year><Month>12</Month><Day>14</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1432-1459</ISSN><JournalIssue CitedMedium="Internet"><Volume>263</Volume><Issue>1</Issue><PubDate><Year>2016</Year><Month>Jan</Month></PubDate></JournalIssue><Title>Journal of neurology</Title><ISOAbbreviation>J. Neurol.</ISOAbbreviation></Journal><ArticleTitle>Referring Parkinson's disease patients for deep brain stimulation: a RAND/UCLA appropriateness study.</ArticleTitle><Pagination><MedlinePgn>112-9</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00415-015-7942-x</ELocationID><Abstract><AbstractText>In 2005, a European expert panel developed and validated an electronic tool to support the appropriate referral of patients with Parkinson's disease (PD) for the consideration of deep brain stimulation (DBS). Since new evidence has become available over the last decade an update of the tool is necessary. A world-wide expert panel (71 neurologists and 11 neurosurgeons) used the RAND/UCLA Appropriateness Method to assess the appropriateness of referral for 1296 scenarios (9-point scale). Scenarios were permutations of 8 clinical variables relevant to the decision of referral. Appropriateness of referral was calculated on the basis of the median score and the extent of agreement. Compared to 2005, the impact of clinical variables on the appropriateness of referral was similar for severity of on-off fluctuations, dyskinesias and refractory tremor (positive association, p < 0.001), and cognitive impairment (negative association, p < 0.001). A relatively stronger negative impact was seen for levodopa-unresponsive gait and balance disturbances as well as older age, the latter most likely due to a higher cut-off value (75 versus 70 years in the previous study). The impact of PD duration on the appropriateness of referral was less pronounced than in 2005. The contribution of the newly included variable 'non-motor side effects of anti-PD medication' was very modest. Based on these results the panel produced new recommendations on the appropriateness of referral for the evaluation of DBS in PD patients. Differences from the previous study reflect the new clinical evidence, particularly related to the use of DBS in an earlier stage of PD. The validation of the updated recommendations is in progress.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Moro</LastName><ForeName>Elena</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Division of Neurology, CHU of Grenoble, Joseph Fourier University, INSERM U836, Grenoble, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schüpbach</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Neurology, Movement Disorders Center, Bern University Hospital and University of Bern, Bern, Switzerland.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Assistance-Publique Hôpitaux de Paris; Centre d'Investigation Clinique 9503, Institut du Cerveau et de la Moelle épinière; Département de Neurologie, Université Pierre et Marie Curie, Paris 6 et INSERM, CHU Pitié-Salpêtrière, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wächter</LastName><ForeName>Tobias</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center of Rehabilitation, Bad Gögging, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Allert</LastName><ForeName>Niels</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Neurological Rehabilitation Center Godeshoehe, Bonn, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eleopra</LastName><ForeName>Roberto</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Neurology, Santa Maria della Misericordia University Hospital, Udine, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Honey</LastName><ForeName>Christopher R</ForeName><Initials>CR</Initials><AffiliationInfo><Affiliation>Division of Neurosurgery, University of British Columbia, Vancouver, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rueda</LastName><ForeName>Mauricio</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Departamento de Neurociencias, Fundación Cardiovascular de Colombia, Bucaramanga, Colombia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schiess</LastName><ForeName>Mya C</ForeName><Initials>MC</Initials><AffiliationInfo><Affiliation>Department of Neurology, University of Texas Medical School at Houston, Texas, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shimo</LastName><ForeName>Yasushi</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Valkovic</LastName><ForeName>Peter</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>2nd Department of Neurology, Comenius University Faculty of Medicine and University Hospital Bratislava, Bratislava, Slovakia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Whone</LastName><ForeName>Alan</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Neurology, Frenchay Hospital, Bristol, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Stoevelaar</LastName><ForeName>Herman</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Centre for Decision Analysis and Support, Ismar Healthcare, Lier, Belgium. herman.stoevelaar@ismar.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>UL1 TR000371</GrantID><Acronym>TR</Acronym><Agency>NCATS NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>11</Month><Day>03</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>J Neurol</MedlineTA><NlmUniqueID>0423161</NlmUniqueID><ISSNLinking>0340-5354</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Mov Disord. 2011 Oct;26 Suppl 3:S2-41</RefSource><PMID Version="1">22021173</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet Neurol. 2012 May;11(5):429-42</RefSource><PMID Version="1">22516078</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Brain. 2012 May;135(Pt 5):1463-77</RefSource><PMID 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UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D046690" MajorTopicYN="Y">Deep Brain Stimulation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017410" MajorTopicYN="N">Practice Guidelines as Topic</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012017" MajorTopicYN="N">Referral and Consultation</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="Y">Severity of Illness Index</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">PMC4723622</OtherID><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Consultation</Keyword><Keyword MajorTopicYN="N">Deep brain stimulation</Keyword><Keyword MajorTopicYN="N">Parkinson’s disease</Keyword><Keyword MajorTopicYN="N">RAND/UCLA appropriateness method</Keyword><Keyword MajorTopicYN="N">Referral</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>08</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>10</Month><Day>13</Day></PubMedPubDate><PubMedPubDate 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