Diagnosing Parkinson's disease using videotaped neurological examinations: Validity and factors that contribute to incorrect diagnoses
Identifieur interne : 001470 ( Istex/Corpus ); précédent : 001469; suivant : 001471Diagnosing Parkinson's disease using videotaped neurological examinations: Validity and factors that contribute to incorrect diagnoses
Auteurs : Elan D. Louis ; Gilberto Levy ; Lucien J. Côte ; Helen Mejia ; Stanley Fahn ; Karen MarderSource :
- Movement Disorders [ 0885-3185 ] ; 2002-05.
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Abstract
Field work is commonly required in movement disorders research. Sending neurologists into the field can be logistically challenging and costly. Alternatively, neurological examinations may be videotaped and reviewed later. There is little knowledge of the validity of the videotaped neurological examination in the diagnosis of Parkinson's disease (PD). We examined the validity of the videotaped Unified Parkinson's Disease Rating Scale (UPDRS) motor examination in the diagnosis of PD, and sought to determine which factors are associated with incorrect diagnoses. PD patients and controls were enrolled in a familial aggregation study between August of 1998 and June of 2000, and as part of that study each was examined by a physician who performed an in‐person UPDRS motor examination. Each also underwent a second, videotaped UPDRS motor examination. Based on the review of this videotape, a neurologist, who was blinded to the previous clinical diagnosis, assigned a diagnosis of PD or normal. A total of 211 of 231 PD patients (sensitivity = 91.3%), and 170 of 172 controls (specificity = 98.8%) were correctly identified based on the videotape. True positives had a higher mean rest tremor score (1.7 vs. 0.3; P < 0.001), action tremor score (0.9 vs. 0.3; P < 0.001), bradykinesia score (11.2 vs. 7.4; P = 0.02), and disease of longer mean duration (8.9 vs. 5.8 years; P = 0.001) than false negatives. False negatives did not differ from true positives in terms of age, total dose of levodopa, Hoehn and Yahr score, or rigidity, gait and posture, or facial masking scores (each assessed during the in‐person examination). The videotaped UPDRS motor examination is a useful means of diagnosing PD and provides an alternative approach for the diagnosis of PD in field studies. A limitation is that patients with milder PD of shorter duration may not be recognized as PD. © 2002 Movement Disorder Society
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DOI: 10.1002/mds.10119
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Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>The Taub Institute for Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. 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Sending neurologists into the field can be logistically challenging and costly. Alternatively, neurological examinations may be videotaped and reviewed later. There is little knowledge of the validity of the videotaped neurological examination in the diagnosis of Parkinson's disease (PD). We examined the validity of the videotaped Unified Parkinson's Disease Rating Scale (UPDRS) motor examination in the diagnosis of PD, and sought to determine which factors are associated with incorrect diagnoses. PD patients and controls were enrolled in a familial aggregation study between August of 1998 and June of 2000, and as part of that study each was examined by a physician who performed an in‐person UPDRS motor examination. Each also underwent a second, videotaped UPDRS motor examination. Based on the review of this videotape, a neurologist, who was blinded to the previous clinical diagnosis, assigned a diagnosis of PD or normal. A total of 211 of 231 PD patients (sensitivity = 91.3%), and 170 of 172 controls (specificity = 98.8%) were correctly identified based on the videotape. True positives had a higher mean rest tremor score (1.7 vs. 0.3; P < 0.001), action tremor score (0.9 vs. 0.3; P < 0.001), bradykinesia score (11.2 vs. 7.4; P = 0.02), and disease of longer mean duration (8.9 vs. 5.8 years; P = 0.001) than false negatives. False negatives did not differ from true positives in terms of age, total dose of levodopa, Hoehn and Yahr score, or rigidity, gait and posture, or facial masking scores (each assessed during the in‐person examination). The videotaped UPDRS motor examination is a useful means of diagnosing PD and provides an alternative approach for the diagnosis of PD in field studies. A limitation is that patients with milder PD of shorter duration may not be recognized as PD. © 2002 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Elan D. Louis MD, MS</name><affiliations><json:string>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string><json:string>The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string></affiliations></json:item><json:item><name>Gilberto Levy MD</name><affiliations><json:string>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</json:string></affiliations></json:item><json:item><name>Lucien J. Côte MD</name><affiliations><json:string>The Gertrude H. 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Sending neurologists into the field can be logistically challenging and costly. Alternatively, neurological examinations may be videotaped and reviewed later. There is little knowledge of the validity of the videotaped neurological examination in the diagnosis of Parkinson's disease (PD). We examined the validity of the videotaped Unified Parkinson's Disease Rating Scale (UPDRS) motor examination in the diagnosis of PD, and sought to determine which factors are associated with incorrect diagnoses. PD patients and controls were enrolled in a familial aggregation study between August of 1998 and June of 2000, and as part of that study each was examined by a physician who performed an in‐person UPDRS motor examination. Each also underwent a second, videotaped UPDRS motor examination. Based on the review of this videotape, a neurologist, who was blinded to the previous clinical diagnosis, assigned a diagnosis of PD or normal. A total of 211 of 231 PD patients (sensitivity = 91.3%), and 170 of 172 controls (specificity = 98.8%) were correctly identified based on the videotape. True positives had a higher mean rest tremor score (1.7 vs. 0.3; P > 0.001), action tremor score (0.9 vs. 0.3; P > 0.001), bradykinesia score (11.2 vs. 7.4; P = 0.02), and disease of longer mean duration (8.9 vs. 5.8 years; P = 0.001) than false negatives. False negatives did not differ from true positives in terms of age, total dose of levodopa, Hoehn and Yahr score, or rigidity, gait and posture, or facial masking scores (each assessed during the in‐person examination). The videotaped UPDRS motor examination is a useful means of diagnosing PD and provides an alternative approach for the diagnosis of PD in field studies. 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Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation></author><author><persName><forename type="first">Gilberto</forename><surname>Levy</surname><roleName type="degree">MD</roleName></persName><affiliation>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation></author><author><persName><forename type="first">Lucien J.</forename><surname>Côte</surname><roleName type="degree">MD</roleName></persName><affiliation>The Gertrude H. 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Alternatively, neurological examinations may be videotaped and reviewed later. There is little knowledge of the validity of the videotaped neurological examination in the diagnosis of Parkinson's disease (PD). We examined the validity of the videotaped Unified Parkinson's Disease Rating Scale (UPDRS) motor examination in the diagnosis of PD, and sought to determine which factors are associated with incorrect diagnoses. PD patients and controls were enrolled in a familial aggregation study between August of 1998 and June of 2000, and as part of that study each was examined by a physician who performed an in‐person UPDRS motor examination. Each also underwent a second, videotaped UPDRS motor examination. Based on the review of this videotape, a neurologist, who was blinded to the previous clinical diagnosis, assigned a diagnosis of PD or normal. A total of 211 of 231 PD patients (sensitivity = 91.3%), and 170 of 172 controls (specificity = 98.8%) were correctly identified based on the videotape. True positives had a higher mean rest tremor score (1.7 vs. 0.3; P < 0.001), action tremor score (0.9 vs. 0.3; P < 0.001), bradykinesia score (11.2 vs. 7.4; P = 0.02), and disease of longer mean duration (8.9 vs. 5.8 years; P = 0.001) than false negatives. False negatives did not differ from true positives in terms of age, total dose of levodopa, Hoehn and Yahr score, or rigidity, gait and posture, or facial masking scores (each assessed during the in‐person examination). The videotaped UPDRS motor examination is a useful means of diagnosing PD and provides an alternative approach for the diagnosis of PD in field studies. A limitation is that patients with milder PD of shorter duration may not be recognized as PD. © 2002 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>epidemiology</term></item><item><term>videotape</term></item><item><term>validity</term></item><item><term>tremor</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Article category</head><item><term>Brief Report</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2001-07-23">Received</change><change when="2001-10-30">Registration</change><change when="2002-05">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/9F71B36EF17D2A4831DF4E055BD671FDBE45690A/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>New York</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="subtitle">Official Journal of the Movement Disorder Society</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="30"><doi origin="wiley" registered="yes">10.1002/mds.v17:3</doi><numberingGroup><numbering type="journalVolume" number="17">17</numbering><numbering type="journalIssue">3</numbering></numberingGroup><coverDate startDate="2002-05">May/June 2002</coverDate></publicationMeta><publicationMeta level="unit" type="shortCommunication" position="120" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.10119</doi><idGroup><id type="unit" value="MDS10119"></id></idGroup><countGroup><count type="pageTotal" number="5"></count></countGroup><titleGroup><title type="articleCategory">Brief Report</title><title type="tocHeading1">Brief Report</title></titleGroup><copyright ownership="thirdParty">Copyright © 2002 Movement Disorders Society</copyright><eventGroup><event type="manuscriptReceived" date="2001-07-23"></event><event type="manuscriptRevised" date="2001-10-15"></event><event type="manuscriptAccepted" date="2001-10-30"></event><event type="publishedOnlineEarlyUnpaginated" date="2002-02-14"></event><event type="firstOnline" date="2002-02-14"></event><event type="publishedOnlineFinalForm" date="2002-05-31"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-03-09"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-01"></event></eventGroup><numberingGroup><numbering type="pageFirst">513</numbering><numbering type="pageLast">517</numbering></numberingGroup><correspondenceTo>Unit 198, Neurological Institute, 710 West 168th Street, New York, New York 10032</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS10119.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="2"></count><count type="referenceTotal" number="14"></count><count type="wordTotal" number="2683"></count></countGroup><titleGroup><title type="main" xml:lang="en">Diagnosing Parkinson's disease using videotaped neurological examinations: Validity and factors that contribute to incorrect diagnoses</title><title type="short" xml:lang="en">Videotaped Neurological Examinations</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2" corresponding="yes"><personName><givenNames>Elan D.</givenNames><familyName>Louis</familyName><degrees>MD, MS</degrees></personName><contactDetails><email>EDL2@columbia.edu</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Gilberto</givenNames><familyName>Levy</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Lucien J.</givenNames><familyName>Côte</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Helen</givenNames><familyName>Mejia</familyName><degrees>MA</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Stanley</givenNames><familyName>Fahn</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1 #af2 #af3"><personName><givenNames>Karen</givenNames><familyName>Marder</familyName><degrees>MD, MPH</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="US" type="organization"><unparsedAffiliation>The Taub Institute for Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">epidemiology</keyword><keyword xml:id="kwd3">videotape</keyword><keyword xml:id="kwd4">validity</keyword><keyword xml:id="kwd5">tremor</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Field work is commonly required in movement disorders research. Sending neurologists into the field can be logistically challenging and costly. Alternatively, neurological examinations may be videotaped and reviewed later. There is little knowledge of the validity of the videotaped neurological examination in the diagnosis of Parkinson's disease (PD). We examined the validity of the videotaped Unified Parkinson's Disease Rating Scale (UPDRS) motor examination in the diagnosis of PD, and sought to determine which factors are associated with incorrect diagnoses. PD patients and controls were enrolled in a familial aggregation study between August of 1998 and June of 2000, and as part of that study each was examined by a physician who performed an in‐person UPDRS motor examination. Each also underwent a second, videotaped UPDRS motor examination. Based on the review of this videotape, a neurologist, who was blinded to the previous clinical diagnosis, assigned a diagnosis of PD or normal. A total of 211 of 231 PD patients (sensitivity = 91.3%), and 170 of 172 controls (specificity = 98.8%) were correctly identified based on the videotape. True positives had a higher mean rest tremor score (1.7 vs. 0.3; <i>P</i> < 0.001), action tremor score (0.9 vs. 0.3; <i>P</i> < 0.001), bradykinesia score (11.2 vs. 7.4; <i>P</i> = 0.02), and disease of longer mean duration (8.9 vs. 5.8 years; <i>P</i> = 0.001) than false negatives. False negatives did not differ from true positives in terms of age, total dose of levodopa, Hoehn and Yahr score, or rigidity, gait and posture, or facial masking scores (each assessed during the in‐person examination). The videotaped UPDRS motor examination is a useful means of diagnosing PD and provides an alternative approach for the diagnosis of PD in field studies. A limitation is that patients with milder PD of shorter duration may not be recognized as PD. © 2002 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 3-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Diagnosing Parkinson's disease using videotaped neurological examinations: Validity and factors that contribute to incorrect diagnoses</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Videotaped Neurological Examinations</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Diagnosing Parkinson's disease using videotaped neurological examinations: Validity and factors that contribute to incorrect diagnoses</title></titleInfo><name type="personal"><namePart type="given">Elan D.</namePart><namePart type="family">Louis</namePart><namePart type="termsOfAddress">MD, MS</namePart><affiliation>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><description>Correspondence: Unit 198, Neurological Institute, 710 West 168th Street, New York, New York 10032</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gilberto</namePart><namePart type="family">Levy</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lucien J.</namePart><namePart type="family">Côte</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Helen</namePart><namePart type="family">Mejia</namePart><namePart type="termsOfAddress">MA</namePart><affiliation>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stanley</namePart><namePart type="family">Fahn</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karen</namePart><namePart type="family">Marder</namePart><namePart type="termsOfAddress">MD, MPH</namePart><affiliation>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>The Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><affiliation>The Taub Institute for Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">shortCommunication</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">New York</placeTerm></place><dateIssued encoding="w3cdtf">2002-05</dateIssued><dateCaptured encoding="w3cdtf">2001-07-23</dateCaptured><dateValid encoding="w3cdtf">2001-10-30</dateValid><copyrightDate encoding="w3cdtf">2002</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">2</extent><extent unit="references">14</extent><extent unit="words">2683</extent></physicalDescription><abstract lang="en">Field work is commonly required in movement disorders research. Sending neurologists into the field can be logistically challenging and costly. Alternatively, neurological examinations may be videotaped and reviewed later. There is little knowledge of the validity of the videotaped neurological examination in the diagnosis of Parkinson's disease (PD). We examined the validity of the videotaped Unified Parkinson's Disease Rating Scale (UPDRS) motor examination in the diagnosis of PD, and sought to determine which factors are associated with incorrect diagnoses. PD patients and controls were enrolled in a familial aggregation study between August of 1998 and June of 2000, and as part of that study each was examined by a physician who performed an in‐person UPDRS motor examination. Each also underwent a second, videotaped UPDRS motor examination. Based on the review of this videotape, a neurologist, who was blinded to the previous clinical diagnosis, assigned a diagnosis of PD or normal. A total of 211 of 231 PD patients (sensitivity = 91.3%), and 170 of 172 controls (specificity = 98.8%) were correctly identified based on the videotape. True positives had a higher mean rest tremor score (1.7 vs. 0.3; P < 0.001), action tremor score (0.9 vs. 0.3; P < 0.001), bradykinesia score (11.2 vs. 7.4; P = 0.02), and disease of longer mean duration (8.9 vs. 5.8 years; P = 0.001) than false negatives. False negatives did not differ from true positives in terms of age, total dose of levodopa, Hoehn and Yahr score, or rigidity, gait and posture, or facial masking scores (each assessed during the in‐person examination). The videotaped UPDRS motor examination is a useful means of diagnosing PD and provides an alternative approach for the diagnosis of PD in field studies. A limitation is that patients with milder PD of shorter duration may not be recognized as PD. © 2002 Movement Disorder Society</abstract><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>epidemiology</topic><topic>videotape</topic><topic>validity</topic><topic>tremor</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. 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