How Cautious Should We Be When Assessing Apathy with the Unified Parkinson's Disease Rating Scale?
Identifieur interne : 002514 ( Main/Exploration ); précédent : 002513; suivant : 002515How Cautious Should We Be When Assessing Apathy with the Unified Parkinson's Disease Rating Scale?
Auteurs : Lindsey Kirsch-Darrow [États-Unis] ; Laura B. Zahodne [États-Unis] ; Chris Hass [États-Unis] ; Ania Mikos [États-Unis] ; Michael S. Okun [États-Unis] ; Hubert H. Fernandez [États-Unis] ; Dawn Bowers [États-Unis]Source :
- Movement disorders [ 0885-3185 ] ; 2009.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
Current practice often assesses apathy with a single item from the Unified Parkinson's Disease Rating Scale (UPDRS, item 4). Yet, the relationship between the UPDRS item 4 and the validated Apathy Scale (AS) is unknown. The purpose of this study was to evaluate the operating characteristics of UPDRS item 4 in relation to the AS. Three hundred and one patients with PD were administered the AS and the UPDRS. We compared the UPDRS item 4 to the standard AS classification of ≥14 as apathetic. A receiver operating characteristics (ROC) curve was obtained, and sensitivity, specificity, positive, and negative predictive power were calculated. The ROC curve showed area under the curve as 0.75. A cut-off of 1 had good sensitivity (81%) but poor specificity (53%; high false positive rate). A cut-off point of 2 had acceptable specificity (87%) but poor sensitivity (52%, high false negative rate). Continuing to increasing the cut-off point (e.g., 3, 4) continues to increase specificity at the expense of dramatically reducing sensitivity. These findings suggest the use of caution when screening for apathy with item 4 due to its poor sensitivity in relation to the AS.
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Zahodne</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Hass, Chris" sort="Hass, Chris" uniqKey="Hass C" first="Chris" last="Hass">Chris Hass</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Applied Physiology and Kinesiology, University of Florida</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Mikos, Ania" sort="Mikos, Ania" uniqKey="Mikos A" first="Ania" last="Mikos">Ania Mikos</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S." last="Okun">Michael S. Okun</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Neurology, University of Florida</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Fernandez, Hubert H" sort="Fernandez, Hubert H" uniqKey="Fernandez H" first="Hubert H." last="Fernandez">Hubert H. Fernandez</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Neurology, University of Florida</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Bowers, Dawn" sort="Bowers, Dawn" uniqKey="Bowers D" first="Dawn" last="Bowers">Dawn Bowers</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></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>Apathy</term><term>Evaluation scale</term><term>Mood disorder</term><term>Nervous system diseases</term><term>Parkinson disease</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Trouble de l'humeur</term><term>Pathologie du système nerveux</term><term>Echelle d'évaluation</term><term>Apathie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Current practice often assesses apathy with a single item from the Unified Parkinson's Disease Rating Scale (UPDRS, item 4). Yet, the relationship between the UPDRS item 4 and the validated Apathy Scale (AS) is unknown. The purpose of this study was to evaluate the operating characteristics of UPDRS item 4 in relation to the AS. Three hundred and one patients with PD were administered the AS and the UPDRS. We compared the UPDRS item 4 to the standard AS classification of ≥14 as apathetic. A receiver operating characteristics (ROC) curve was obtained, and sensitivity, specificity, positive, and negative predictive power were calculated. The ROC curve showed area under the curve as 0.75. A cut-off of 1 had good sensitivity (81%) but poor specificity (53%; high false positive rate). A cut-off point of 2 had acceptable specificity (87%) but poor sensitivity (52%, high false negative rate). Continuing to increasing the cut-off point (e.g., 3, 4) continues to increase specificity at the expense of dramatically reducing sensitivity. These findings suggest the use of caution when screening for apathy with item 4 due to its poor sensitivity in relation to the AS.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Floride</li></region></list><tree><country name="États-Unis"><region name="Floride"><name sortKey="Kirsch Darrow, Lindsey" sort="Kirsch Darrow, Lindsey" uniqKey="Kirsch Darrow L" first="Lindsey" last="Kirsch-Darrow">Lindsey Kirsch-Darrow</name></region><name sortKey="Bowers, Dawn" sort="Bowers, Dawn" uniqKey="Bowers D" first="Dawn" last="Bowers">Dawn Bowers</name><name sortKey="Fernandez, Hubert H" sort="Fernandez, Hubert H" uniqKey="Fernandez H" first="Hubert H." last="Fernandez">Hubert H. Fernandez</name><name sortKey="Hass, Chris" sort="Hass, Chris" uniqKey="Hass C" first="Chris" last="Hass">Chris Hass</name><name sortKey="Mikos, Ania" sort="Mikos, Ania" uniqKey="Mikos A" first="Ania" last="Mikos">Ania Mikos</name><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S." last="Okun">Michael S. Okun</name><name sortKey="Zahodne, Laura B" sort="Zahodne, Laura B" uniqKey="Zahodne L" first="Laura B." last="Zahodne">Laura B. Zahodne</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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