The Use of a Color Coded Probability Scale to Interpret Smell Tests in Suspected Parkinsonism
Identifieur interne : 002491 ( Main/Exploration ); précédent : 002490; suivant : 002492The Use of a Color Coded Probability Scale to Interpret Smell Tests in Suspected Parkinsonism
Auteurs : Laura Silveira-Moriyama [Royaume-Uni] ; Aviva Petrie [Royaume-Uni] ; David R. Williams [Australie] ; Andrew Evans [Australie] ; Regina Katzenschlager [Autriche] ; Egberto R. Barbosa [Brésil] ; Andrew Lees (neurologue) [Royaume-Uni]Source :
- Movement disorders [ 0885-3185 ] ; 2009.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
Smell identification tests (SITs) have been suggested as useful in the differential diagnosis of Parkinson's disease (PD). We have applied the 40 item University of Pennsylvania SIT (UPSIT-40) and/or the 16 item SIT from Sniffin Sticks (SS-16) to 193 nondemented PD patients and 157 controls and used logistic regression analysis to associate the SIT result with the probability of an individual patient having PD ("PD probability"). Reliability measures (95% CI) using the clinical diagnosis as a gold standard and a dichotomized result of the smell test into high (50% or more) or low (<50%) "PD probability" were: sensitivity 85.0% (78.8-89.7%), specificity 84.6% (77.3-89.9%) for the UPSIT-40; sensitivity 90.4% (83.5-94.7%), specificity 85.5% (76.2-91.7%) for the SS-16. Based on these findings we have created color coded visual tools (PD probability rulers) and applied them to 39 clinically uncertain parkinsonian syndromes (CUPS) patients who had been investigated with dopamine transporter SPECT scanning using [123-I]-FP-CIT SPECT (DaTSCAN) for suspected Parkinson's disease. In 32 of 36 CUPS cases (88.9%, kappa = 0.72) the probability ruler predicted the result of the DaTS-CAN. We suggest smell tests could be used routinely in challenging cases where there is diagnostic uncertainty and help inform decision making relating to the need for neuro imaging.
Affiliations:
- Australie, Autriche, Brésil, Royaume-Uni
- Angleterre, Grand Londres, Vienne (Autriche), État de São Paulo
- Londres, São Paulo, Vienne (Autriche)
- National Hospital for Neurology and Neurosurgery
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Barbosa</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Neurology Department, Sao Paulo School of Medicine</s1><s2>Sao Paulo</s2><s3>BRA</s3><sZ>6 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Lees, Andrew J" sort="Lees, Andrew J" uniqKey="Lees A" first="Andrew J." last="Lees">Andrew Lees (neurologue)</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName>National Hospital for Neurology and Neurosurgery</orgName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Color</term><term>Nervous system diseases</term><term>Olfaction</term><term>Parkinson disease</term><term>Parkinsonism</term><term>Probability</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinsonisme</term><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Couleur</term><term>Probabilité</term><term>Olfaction</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Smell identification tests (SITs) have been suggested as useful in the differential diagnosis of Parkinson's disease (PD). We have applied the 40 item University of Pennsylvania SIT (UPSIT-40) and/or the 16 item SIT from Sniffin Sticks (SS-16) to 193 nondemented PD patients and 157 controls and used logistic regression analysis to associate the SIT result with the probability of an individual patient having PD ("PD probability"). Reliability measures (95% CI) using the clinical diagnosis as a gold standard and a dichotomized result of the smell test into high (50% or more) or low (<50%) "PD probability" were: sensitivity 85.0% (78.8-89.7%), specificity 84.6% (77.3-89.9%) for the UPSIT-40; sensitivity 90.4% (83.5-94.7%), specificity 85.5% (76.2-91.7%) for the SS-16. Based on these findings we have created color coded visual tools (PD probability rulers) and applied them to 39 clinically uncertain parkinsonian syndromes (CUPS) patients who had been investigated with dopamine transporter SPECT scanning using [123-I]-FP-CIT SPECT (DaTSCAN) for suspected Parkinson's disease. In 32 of 36 CUPS cases (88.9%, kappa = 0.72) the probability ruler predicted the result of the DaTS-CAN. We suggest smell tests could be used routinely in challenging cases where there is diagnostic uncertainty and help inform decision making relating to the need for neuro imaging.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Autriche</li><li>Brésil</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Vienne (Autriche)</li><li>État de São Paulo</li></region><settlement><li>Londres</li><li>São Paulo</li><li>Vienne (Autriche)</li></settlement><orgName><li>National Hospital for Neurology and Neurosurgery</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Silveira Moriyama, Laura" sort="Silveira Moriyama, Laura" uniqKey="Silveira Moriyama L" first="Laura" last="Silveira-Moriyama">Laura Silveira-Moriyama</name></region><name sortKey="Lees, Andrew J" sort="Lees, Andrew J" uniqKey="Lees A" first="Andrew J." last="Lees">Andrew Lees (neurologue)</name><name sortKey="Petrie, Aviva" sort="Petrie, Aviva" uniqKey="Petrie A" first="Aviva" last="Petrie">Aviva Petrie</name></country><country name="Australie"><noRegion><name sortKey="Williams, David R" sort="Williams, David R" uniqKey="Williams D" first="David R." last="Williams">David R. Williams</name></noRegion><name sortKey="Evans, Andrew" sort="Evans, Andrew" uniqKey="Evans A" first="Andrew" last="Evans">Andrew Evans</name></country><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Katzenschlager, Regina" sort="Katzenschlager, Regina" uniqKey="Katzenschlager R" first="Regina" last="Katzenschlager">Regina Katzenschlager</name></region></country><country name="Brésil"><region name="État de São Paulo"><name sortKey="Barbosa, Egberto R" sort="Barbosa, Egberto R" uniqKey="Barbosa E" first="Egberto R." last="Barbosa">Egberto R. Barbosa</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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