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
Links to Exploration step
pubmed:19185011Le document en format XML
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<author><name sortKey="Kirsch Darrow, Lindsey" sort="Kirsch Darrow, Lindsey" uniqKey="Kirsch Darrow L" first="Lindsey" last="Kirsch-Darrow">Lindsey Kirsch-Darrow</name>
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<author><name sortKey="Zahodne, Laura B" sort="Zahodne, Laura B" uniqKey="Zahodne L" first="Laura B" last="Zahodne">Laura B. Zahodne</name>
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<author><name sortKey="Hass, Chris" sort="Hass, Chris" uniqKey="Hass C" first="Chris" last="Hass">Chris Hass</name>
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<author><name sortKey="Mikos, Ania" sort="Mikos, Ania" uniqKey="Mikos A" first="Ania" last="Mikos">Ania Mikos</name>
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<author><name sortKey="Fernandez, Hubert H" sort="Fernandez, Hubert H" uniqKey="Fernandez H" first="Hubert H" last="Fernandez">Hubert H. Fernandez</name>
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<author><name sortKey="Bowers, Dawn" sort="Bowers, Dawn" uniqKey="Bowers D" first="Dawn" last="Bowers">Dawn Bowers</name>
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<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>
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<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>
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