How cautious should we be when assessing apathy with the Unified Parkinson's Disease Rating Scale?
Identifieur interne : 001E57 ( PubMed/Corpus ); précédent : 001E56; suivant : 001E58How cautious should we be when assessing apathy with the Unified Parkinson's Disease Rating Scale?
Auteurs : Lindsey Kirsch-Darrow ; Laura B. Zahodne ; Chris Hass ; Ania Mikos ; Michael S. Okun ; Hubert H. Fernandez ; Dawn BowersSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2009.
English descriptors
- KwdEn :
- MESH :
- complications : Parkinson Disease.
- diagnosis : Mood Disorders.
- etiology : Mood Disorders.
- psychology : Parkinson Disease.
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, ROC Curve, Sensitivity and Specificity.
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 > or =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.
DOI: 10.1002/mds.22437
PubMed: 19185011
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">How cautious should we be when assessing apathy with the Unified Parkinson's Disease Rating Scale?</title><author><name sortKey="Kirsch Darrow, Lindsey" sort="Kirsch Darrow, Lindsey" uniqKey="Kirsch Darrow L" first="Lindsey" last="Kirsch-Darrow">Lindsey Kirsch-Darrow</name><affiliation><nlm:affiliation>Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida 32610-0165, USA. lkirsch@phhp.ufl.edu</nlm:affiliation></affiliation></author><author><name sortKey="Zahodne, Laura B" sort="Zahodne, Laura B" uniqKey="Zahodne L" first="Laura B" last="Zahodne">Laura B. Zahodne</name></author><author><name sortKey="Hass, Chris" sort="Hass, Chris" uniqKey="Hass C" first="Chris" last="Hass">Chris Hass</name></author><author><name sortKey="Mikos, Ania" sort="Mikos, Ania" uniqKey="Mikos A" first="Ania" last="Mikos">Ania Mikos</name></author><author><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S" last="Okun">Michael S. Okun</name></author><author><name sortKey="Fernandez, Hubert H" sort="Fernandez, Hubert H" uniqKey="Fernandez H" first="Hubert H" last="Fernandez">Hubert H. Fernandez</name></author><author><name sortKey="Bowers, Dawn" sort="Bowers, Dawn" uniqKey="Bowers D" first="Dawn" last="Bowers">Dawn Bowers</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2009">2009</date><idno type="doi">10.1002/mds.22437</idno><idno type="RBID">pubmed:19185011</idno><idno type="pmid">19185011</idno><idno type="wicri:Area/PubMed/Corpus">001E57</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">How cautious should we be when assessing apathy with the Unified Parkinson's Disease Rating Scale?</title><author><name sortKey="Kirsch Darrow, Lindsey" sort="Kirsch Darrow, Lindsey" uniqKey="Kirsch Darrow L" first="Lindsey" last="Kirsch-Darrow">Lindsey Kirsch-Darrow</name><affiliation><nlm:affiliation>Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida 32610-0165, USA. lkirsch@phhp.ufl.edu</nlm:affiliation></affiliation></author><author><name sortKey="Zahodne, Laura B" sort="Zahodne, Laura B" uniqKey="Zahodne L" first="Laura B" last="Zahodne">Laura B. Zahodne</name></author><author><name sortKey="Hass, Chris" sort="Hass, Chris" uniqKey="Hass C" first="Chris" last="Hass">Chris Hass</name></author><author><name sortKey="Mikos, Ania" sort="Mikos, Ania" uniqKey="Mikos A" first="Ania" last="Mikos">Ania Mikos</name></author><author><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S" last="Okun">Michael S. Okun</name></author><author><name sortKey="Fernandez, Hubert H" sort="Fernandez, Hubert H" uniqKey="Fernandez H" first="Hubert H" last="Fernandez">Hubert H. Fernandez</name></author><author><name sortKey="Bowers, Dawn" sort="Bowers, Dawn" uniqKey="Bowers D" first="Dawn" last="Bowers">Dawn Bowers</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2009" type="published">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Mood Disorders (diagnosis)</term><term>Mood Disorders (etiology)</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (psychology)</term><term>Psychiatric Status Rating Scales</term><term>ROC Curve</term><term>Sensitivity and Specificity</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Mood Disorders</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Mood Disorders</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Psychiatric Status Rating Scales</term><term>ROC Curve</term><term>Sensitivity and Specificity</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 > or =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><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">19185011</PMID><DateCreated><Year>2009</Year><Month>05</Month><Day>04</Day></DateCreated><DateCompleted><Year>2009</Year><Month>07</Month><Day>28</Day></DateCompleted><DateRevised><Year>2014</Year><Month>09</Month><Day>22</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1531-8257</ISSN><JournalIssue CitedMedium="Internet"><Volume>24</Volume><Issue>5</Issue><PubDate><Year>2009</Year><Month>Apr</Month><Day>15</Day></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>How cautious should we be when assessing apathy with the Unified Parkinson's Disease Rating Scale?</ArticleTitle><Pagination><MedlinePgn>684-8</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/mds.22437</ELocationID><Abstract><AbstractText>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 > or =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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kirsch-Darrow</LastName><ForeName>Lindsey</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida 32610-0165, USA. lkirsch@phhp.ufl.edu</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zahodne</LastName><ForeName>Laura B</ForeName><Initials>LB</Initials></Author><Author ValidYN="Y"><LastName>Hass</LastName><ForeName>Chris</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Mikos</LastName><ForeName>Ania</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Okun</LastName><ForeName>Michael S</ForeName><Initials>MS</Initials></Author><Author ValidYN="Y"><LastName>Fernandez</LastName><ForeName>Hubert H</ForeName><Initials>HH</Initials></Author><Author ValidYN="Y"><LastName>Bowers</LastName><ForeName>Dawn</ForeName><Initials>D</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>F31-NS059142</GrantID><Acronym>NS</Acronym><Agency>NINDS NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>K23-NS044997</GrantID><Acronym>NS</Acronym><Agency>NINDS NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01-NS05063</GrantID><Acronym>NS</Acronym><Agency>NINDS NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>T32 AG020499</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>T32 AG020499-09</GrantID><Acronym>AG</Acronym><Agency>NIA NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D023362">Evaluation Studies</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Mov Disord. 2002 Mar;17(2):366-71</RefSource><PMID Version="1">11921125</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neurol Neurosurg Psychiatry. 2002 Dec;73(6):636-42</RefSource><PMID Version="1">12438462</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Affect Disord. 2004 Feb;78(2):131-40</RefSource><PMID Version="1">14706723</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neurol Neurosurg Psychiatry. 1992 Mar;55(3):181-4</RefSource><PMID Version="1">1564476</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neuropsychiatry Clin Neurosci. 1991 Summer;3(3):243-54</RefSource><PMID Version="1">1821241</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neuropsychiatry Clin Neurosci. 1992 Spring;4(2):134-9</RefSource><PMID Version="1">1627973</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neurol Neurosurg Psychiatry. 2008 Oct;79(10):1088-92</RefSource><PMID Version="1">18187477</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neurol Neurosurg Psychiatry. 1999 Oct;67(4):492-6</RefSource><PMID Version="1">10486397</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Neurol Neurosurg Psychiatry. 2006 May;77(5):579-84</RefSource><PMID Version="1">16614016</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Neurology. 2006 Jul 11;67(1):33-8</RefSource><PMID Version="1">16832074</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Mov Disord. 2007 Nov 15;22(15):2156-61</RefSource><PMID Version="1">17721877</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Parkinsonism Relat Disord. 2008;14(3):183-6</RefSource><PMID Version="1">17889589</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Clin Chem. 1993 Apr;39(4):561-77</RefSource><PMID Version="1">8472349</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000328">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000369">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005260">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName 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